SAGES guideline for the diagnosis and treatment of appendicitis
Authors
Sunjay S. Kumar, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Amelia T. Collings, Hiram C. Polk, Jr Department of Surgery, University of Louisville, Louisville, KY, USA.
Ryan Lamm, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Ivy N. Haskins, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Stefan Scholz, Division of General and Thoracic Pediatric Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Pramod Nepal, Division of Colon & Rectal Surgery, University of Illinois at Chicago, Chicago, IL, USA.
Arianne T. Train, Department of Surgery, Penn Medicine Lancaster General Health, Lancaster, PA, USA.
Dimitrios I. Athanasiadis, Department of General Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
Philip H. Pucher, School of Pharmacy and Biosciences, University of Portsmouth & Department of General Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth, UK.
Joel F. Bradley, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Nader M. Hanna, Department of Surgery, Queen's University, Kingston, ON, Canada.
Francisco Quinteros, Advocate Health - Midwest
Nisha Narula, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
Bethany J. Slater, University of Chicago Medicine, 5841 S. Maryland Avenue, MC 4062, Chicago, IL, USA. bjslater1@gmail.com.Follow
Recommended Citation
Kumar SS, Collings AT, Lamm R, et al. SAGES guideline for the diagnosis and treatment of appendicitis. Surg Endosc. 2024;38(6):2974-2994. doi:10.1007/s00464-024-10813-y
Abstract
Background:Appendicitis is an extremely common disease with a variety of medical and surgical treatment approaches. A multidisciplinary expert panel was convened to develop evidence-based recommendations to support clinicians and patients in decisions regarding the diagnosis and treatment of appendicitis.
Methods:A systematic review was conducted from 2010 to 2022 to answer 8 key questions relating to the diagnosis of appendicitis, operative or nonoperative management, and specific technical and post-operative issues for appendectomy. The results of this systematic review were then presented to a panel of adult and pediatric surgeons. Evidence-based recommendations were formulated using the GRADE methodology by subject experts.
Results:Conditional recommendations were made in favor of uncomplicated and complicated appendicitis being managed operatively, either delayed (>12h) or immediate operation (
Conclusions:These recommendations should provide guidance with regard to current controversies in appendicitis. The panel also highlighted future research opportunities where the evidence base can be strengthened.
Affiliations
Advocate Lutheran General Hospital