Appendicitis: The Treatments

Home of Kyle J. Norton for The Better of Living & Living Health Appendicitis is defined as a condition of inflammation of Appendix. It is classified  as an emergency, in many required the removal of the appendix. If burst, or perforate, spilling infectious materials into the abdominal cavity can be life threatening.
VI. Treatments
A. In conventional medicine perspective 
1. Laparoscopic and Open Appendectomy
In the study using the data from the 2007 to 2009 Taiwan National Health Insurance Research Database. The study sample included 65,339 patients, hospitalized with a discharge diagnosis of acute appendicitis (33.8% underwent laparoscopic appendectomy). A generalized estimated equation (GEE) was performed to explore the relationship between the use of laparoscopy and 30-day re-admission. Hierarchical linear regressions were performed to examine the relationship between the use of laparoscopy, the length of stay (LOS), and the cost per discharge, showed that a significantly lower proportion of patients undergoing laparoscopic appendectomies were re-admitted within 30 days of their index appendectomy, in comparison to patients undergoing open appendectomies (0.66% versus 1.925, p<0.001). Compared with patients undergoing open appendectomies, patients undergoing laparoscopic appendectomies had a shorter LOS (4.01 versus 5.33 days, p<0.001) and a higher cost per discharge (NT$40,554 versus NT$38,509, p<0.001. In 2007, the average exchange rate was US$1 = NT$31.0). GEE revealed that the odds ratio of 30-day readmission for patients undergoing laparoscopic appendectomy was 0.38 (95% CI = 0.33-0.46) that of patients undergoing open appendectomies, after adjusting for surgeon, hospital, and patient characteristics, as well as for the clustering effect of particular surgeons and the propensity score(35).
 
2. Draining an abscess before appendix surgery 
If in case if your appendix has burst and an abscess has formed around it. In the study to analyze retrospectively our experience with this disease to value the results of drainage of the abscess and appendectomy in one stage in presence of appendiceal abscesses, showed that preoperative ultrasonography showed an accuracy of 85.7% in detecting the presence of an abscess. Mean size of the abscesses were 5 cm (from a minimum of 3 cm to a maximum of 9 cm). The mean duration of surgical operation was 48 minutes (min 35′-max 95′), with a mean in-hospital stay of 6.2 days. Morbidity rate was 9% and was due in 75% of cases to wound infection and in 25% of cases to wound dehiscence. Neither major morbidity nor mortality were observed. In consideration of the results the authors conclude that even in presence of an appendiceal abscess, appendectomy with abscess drainage is not only a safe operation with a low morbidity rate but the procedure of choice allowing a significative reduction of hospitalization and health cost(36).

B. In Herbal medicine perspective 
1. Phaseolus angularis Wight (adzuki bean)
Phaseolus angularis Wight (adzuki bean) is an ethnopharmacologically well-known folk medicine that is prescribed for infection, edema, and inflammation of the joints, appendix, kidney and bladder in Korea, China and Japan. According to the study by the, Pa-EE dose-dependently suppressed the release of PGE(2) and NO in LPS-, Poly(I:C)-, and pam3CSK-activated macrophages. Phaseolus angularis ethanol extract (Pa-EE) strongly down-regulated LPS-induced mRNA expression of inducible NO synthase (iNOS) and cyclooxygenase (COX)-2. Interestingly, Pa-EE markedly inhibited NF-κB, activator protein (AP)-1, and cAMP response element binding protein (CREB) activation; further, according to direct kinase assays and immunoblot analyses, Pa-EE blocked the activation of the upstream signaling molecules spleen tyrosine kinase (Syk), p38, and transforming growth factor β-activated kinase 1 (TAK1). Finally, orally administered Pa-EE clearly ameliorated EtOH/HCl-induced gastritis in mice(37).

2. Cinnamomum cassia 
Cinnamomum cassia Blume (Aceraceae) has been traditionally used to treat various inflammatory diseases such as gastritis. According to the study by the Sungkyunkwan University,  95% ethanol extract (Cc-EE) of Cinnamomum cassia exerts strong anti-inflammatory activity by suppressing Src/Syk-mediated NF-κB activation, which contributes to its major ethno-pharmacological role as an anti-gastritis remedy. Future work will be focused on determining whether the extract can be further developed as an anti-inflammatory drug(38).
 
C. In Traditional Chinese medicine perspective 
Traditional Chinese medicine on a weight basis, includes 190-210 parts of gentrin knotweed, 190-210 parts of sargentodoxa cuneata, 190-210 parts of common reed rhizome, and 140-160 parts of licorice. The medication  has the effects of clearing heat clearing and removing toxicity, antibiosis and antiphlogosis, dispelling wind and expelling parasites, dispersing blood stasis and relieving pain, removing edema and dissipating binds on acute and chronic appendicitis patients, can gradually restore the appendix tissue and the functions, causes less recurrence after a patient is cured, is convenient for use, can reduce pain, has no toxic or side effect, and is cheap and highly-effective, according to the Abstract of study (English, CN 102266504 B) posted in Ip.com(39).
 
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Sources
(35) http://www.ncbi.nlm.nih.gov/pubmed/23874710
(36) http://www.ncbi.nlm.nih.gov/pubmed/9228826
(37) http://www.ncbi.nlm.nih.gov/pubmed/21821108
(38) http://www.ncbi.nlm.nih.gov/pubmed/22155395
(39) http://ip.com/patfam/en/45049084  http://medicaladvisorjournals.blogspot.com