ZenToks Publication

Chapter 18

Endoscopic Retrograde Appendicitis Therapy for Acute Appendicitis: A Review

Abstract/Preface

Acute appendicitis continues to be a prevalent surgical emergency globally, traditionally addressed through appendectomy or, more recently, conservative antibiotic treatment. In recent years, endoscopic retrograde appendicitis therapy (ERAT) has emerged as an innovative, minimally invasive technique that preserves the appendix. ERAT employs colonoscopic access to the appendiceal orifice, facilitating decompression, irrigation, removal of obstructive materials such as fecaliths, and stent placement when necessary. Evidence indicates that ERAT achieves high technical and clinical success rates, with reduced post-procedural pain, shorter recovery periods, and preservation of appendiceal function. Nonetheless, challenges such as recurrence risk, operator dependency, limited global availability, and the absence of standardized protocols remain. ERAT has the potential to transform the treatment paradigm for appendicitis, particularly for patients seeking non-surgical management or those at high surgical risk. This chapter examines the role of ERAT in managing acute appendicitis, encompassing its procedural techniques, indications, clinical outcomes, advantages, limitations, and future perspectives.