As Evidências da Abordagem Cirúrgica na Apendicite

Abstract

Acute appendicitis is a common condition, with a lifetime risk of 1 in 11 people. Guidelines for diagnosis vary, with multiple clinical prediction rules suggested over the past decades. Some approaches advocate the use of clinical scores to stratify risk and guide the use of imaging tests or directly indicate surgery, while others recommend imaging for all suspected cases. This is an integrative literature review with a descriptive and explanatory nature. To conduct the study, the following guiding question was defined: "What are the evidence-based surgical management strategies for appendicitis?" The literature search was carried out through a survey of scientific productions, using databases available in the Virtual Health Library (VHL). A total of 500 studies were retrieved, and after selective filtering according to the proposal, 20 were included in the final analysis. In terms of treatment, recent studies indicate that antibiotics are not inferior to appendectomy in the initial management of acute appendicitis. However, the need for subsequent appendectomy in approximately 30% of cases treated with antibiotics suggests that these approaches may be complementary rather than mutually exclusive. Therefore, the choice of treatment should consider the individual characteristics of patients, and distinguishing between complicated and uncomplicated appendicitis is essential for personalizing the therapeutic approach. Additionally, most patients who initially received conservative treatment eventually required surgical intervention.