Interval appendectomy in complicated appendicitis: Clinical, imaging, and histopathological features at a private center in Peru

Marcos-Enriquez J.C.; Herrera-Matta J.J.; Rodríguez-Alegría C. · Revista Colombiana de Cirugia (2026) · DOI: 10.30944/20117582.3171

Resumen

Introduction. Acute appendicitis complicated by phlegmon or abscess remains a therapeutic challenge regarding non-operative management (NOM) and the need for interval appendectomy (IA). Although IA may reduce initial morbidity and allow for the detection of appendicular neoplasms, the optimal timing and factors associated with NOM failure remain uncertain. The objective of this study was to describe the clinical, imaging, surgical, and histopathological characteristics of patients undergoing IA at a Peruvian center, evaluating factors associated with NOM failure and the surgical interval. Methods. A descriptive, cross-sectional study of adult patients with complicated appendicitis who underwent interval appendectomy following non-operative management between 2022 and 2024 at Clínica Sanna in Lima, Peru. Variables were analyzed using descriptive statistics, Fisher’s exact test, and the Mann-Whitney U test. Results. Of 614 appendectomies, nine (1.5%) were interval appendectomies; 77.8% of the patients were women, with a mean age of 50 years. 67% presented with an abscess and 33% with a fecalith, with no significant association regarding surgical planning. The median interval between non-operative management and surgery was 69 days (IQR: 46-115). A laparoscopic approach was employed in eight cases, with one conversion to open surgery. Morbidity was minimal (one case of postoperative ileus). Eight surgical specimens showed acute inflammation, and one showed chronic inflammation, with no evidence of neoplasia. Conclusions. Interval appendectomy is an infrequent but safe procedure, with high laparoscopic feasibility and low morbidity. The variability in the surgical interval highlights the need to standardize management criteria.