An oncologist comments on appendicitis. A surgeon sets him straight.

It was an interesting fortnight for the debate about the treatment of appendicitis. On November 1, David Agus, a medical oncologist, and director of the University Of Southern California’s Center for Applied Molecular Medicine, had some thoughts about how appendicitis should be treated. He cited the Finnish randomized trial of antibiotics vs. surgery and said a 70 percent cure rate was good enough. In a brief article on the Fortune magazine website, Agus wondered why appendectomy “continues to reign supreme.” He said it was “because 24/7 we’re taught you have to take it out if there’s appendicitis” and that the healthcare community is “stubborn and pigheaded” [pigheaded means stubborn] and that we focus on treatment instead of prevention. Because I am not aware of any method of preventing appendicitis, I say, “Guilty as charged.” I admit I cured appendicitis for my entire professional life. Only five days before Agus’s rant, a meta-analysis of six randomized trials comparing the nonoperative treatment of appendicitis to surgery appeared online in the Journal of the American College of Surgeons. Agus should read it. The authors, surgeons and biomedical researchers from Oxford, England, covered many of the points that I have made in my posts on this subject. Some of their major findings were as follows: In the six studies, 71 percent of the patients underwent open appendectomy which is not the standard in Europe or th...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Surgery Source Type: blogs