Review
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2021; 9(20): 5372-5390
Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5372
Revisiting delayed appendectomy in patients with acute appendicitis
Jian Li
Jian Li, Department of General Surgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang 621000, Sichuan Province, China
Author contributions: Li J designed the review, reviewed the literature, and drafted the manuscript
Conflict-of-interest statement: The author declares no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Li, MM, Surgical Oncologist, Department of General Surgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, No. 190 East Section of Jiannan Road, Youxian District, Mianyang 621000, Sichuan Province, China. 654747973@qq.com
Received: March 20, 2021
Peer-review started: March 20, 2021
First decision: April 23, 2021
Revised: May 4, 2021
Accepted: May 19, 2021
Article in press: May 19, 2021
Published online: July 16, 2021
Processing time: 109 Days and 2.9 Hours
Abstract

Acute appendicitis (AA) is the most common acute abdomen, and appendectomy is the most common nonelective surgery performed worldwide. Despite the long history of understanding this disease and enhancements to medical care, many challenges remain in the diagnosis and treatment of AA. One of these challenges is the timing of appendectomy. In recent decades, extensive studies focused on this topic have been conducted, but there have been no conclusive answers. From the onset of symptoms to appendectomy, many factors can cause delay in the surgical intervention. Some are inevitable, and some can be modified and improved. The favorable and unfavorable results of these factors vary according to different situations. The purpose of this review is to discuss the causes of appendectomy delay and its risk-related costs. This review also explores strategies to balance the positive and negative effects of delayed appendectomy.

Keywords: Acute appendicitis; Appendectomy; Delay; Perforation; Postoperative complications

Core Tip: Extensive research has been conducted on the association between delay in appendectomy and the outcomes of patients, and data on this topic are controversial. I herein discuss the causes of appendectomy delay and its risk-related costs. I also explore strategies to balance the positive and negative effects of delayed appendectomy, aiming to shorten the waiting time before appendectomy and improve the prognosis of this disease.