Endoscopic Retrograde Appendicitis Therapy Versus Laparoscopic Appendectomy for Acute Appendicitis: A 10-Year Single-Center Retrospective Cohort Study
In brief
Endoscopic appendicitis therapy succeeds in 85% but recurs in 15% versus surgery
In a propensity-matched cohort of 122 patients per group, endoscopic retrograde appendicitis therapy achieved 85% one-year success, compared with 98% after laparoscopic appendectomy, and had a 13% recurrence rate versus none after surgery. Although ERAT shortened procedure time, fasting, analgesic use and hospital costs, the higher failure and recurrence risk limits its role pending larger trials.
- Journal
- Clinical and translational gastroenterology (Q1)
- Published
- 9 September 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Zixuan Wang, Yongkang Lai, Yong Zhu, Yin Zhu, Linhui Zheng, Shunhua Long, et al.
- PMID
- 42714415
- DOI
- 10.14309/ctg.0000000000001094
Why clinicians should know about it
- Picked for Surgery (paper of the day, 14 September 2026): Propensity-matched cohort, ERAT vs laparoscopic appendectomy
Abstract
INTRODUCTION: Endoscopic retrograde appendicitis therapy (ERAT) is a minimally invasive, organ-preserving treatment for acute appendicitis (AA), but comparative evidence with laparoscopic appendectomy (LA) remains limited.. METHODS: We retrospectively analyzed 450 patients with AA who underwent ERAT or LA between January 2016 and December 2025. A 1:1 propensity score-matched cohort was established. The primary endpoint was 1-year treatment success. Secondary endpoints included perioperative recovery, healthcare utilization, clinically relevant complications, recurrence, and salvage treatment.. RESULTS: After matching, 122 patients were included in each group. One-year treatment success was lower after ERAT than after LA (104/122 [85.2%] vs 120/122 [98.4%]; P < 0.001). ERAT was associated with shorter operative/procedure time (48.0 vs 74.0 min), shorter postoperative fasting (1.0 vs 3.0 days), lower analgesic use (2.5% vs 64.8%), and lower hospitalization costs (12,306 vs 15,746 CNY; all P < 0.001). Clinically relevant complications occurred in 4.9% and 13.9% of patients, respectively (P = 0.027). During follow-up, recurrence occurred in 16 ERAT-treated patients and in no LA-treated patients (13.1% vs 0%). Most recurrences occurred within 6 months, and all recurrent cases achieved clinical resolution after salvage treatment.. CONCLUSIONS: ERAT had a lower 1-year treatment success rate than LA but was associated with faster recovery and lower hospitalization costs. Recurrences occurred mainly within 6 months and were successfully managed with salvage treatment. These findings highlight the trade-off between short-term recovery and recurrence risk. Prospective multicenter randomized trials are needed to clarify the clinical role and patient-selection criteria for ERAT.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.