Comparing Surgery and Non-Surgery Treatments for Adults with Appendicitis and Abscess or Phlegmon

What this Trial Is About

This research aims to compare early surgery versus non-surgery treatment for adults with complicated appendicitis confirmed by CT scan showing phlegmon or abscess larger than 2 centimeters. The study addresses the ongoing debate about the best approach to manage this condition, as current treatments vary and prior trials outside the United States have suggested benefits of surgery but lack high-quality US data. The goal is to see which approach leads to better outcomes for patients in multiple US centers. Participants who choose surgery will undergo laparoscopic removal of the appendix through small incisions along with draining any abscess present during the same operation. In some cases, open surgery or additional intestinal procedures may be needed. Those opting for non-operative management will receive antibiotics, and if an abscess is present and can be drained, this will be done without surgery. The study allows patients to choose their treatment, and both groups receive standard care appropriate to their assigned approach. During the study, participants will be monitored for hospital stay length, need for further interventions, complications, abscess development, and quality of life related to gastrointestinal health. Evaluations include follow-up for up to one year to track recurrence, delayed surgery, or other outcomes. The study collects data on disability days and any malignancy found in removed tissue. Safety measures and treatment success are carefully assessed over time to understand the best management for complicated appendicitis.

Operative Versus Non-Operative Management for Appendicitis With Abscess or Phlegmon