MANAGEMENT OF APPENDICULAR MASS: A COMPARATIVE STUDY BETWEEN PERCUTANEOUS DRAINAGE AND SURGICAL REMOVAL

Abstract

Background: Appendicular mass is a common sequela of complicated appendicitis, often presenting as localized abscess or phlegmon. The traditional approach of interval appendectomy after conservative management is being challenged by minimally invasive techniques such as percutaneous drainage. This study compares outcomes of percutaneous drainage versus surgical removal in managing appendicular mass.

Methods: A prospective observational study was conducted at Saveetha Medical College from January–December 2024, including 80 patients diagnosed with appendicular mass. Patients were divided into Group A (percutaneous drainage, n=40) and Group B (surgical removal, n=40). Demographics, operative details, complications, hospital stay, recurrence, and 90-day outcomes were analyzed. Statistical significance was assessed using Chi-square and Student’s t-test (p<0.05).

Results: Percutaneous drainage was associated with shorter operative time (mean 45 vs 95 minutes, p<0.001), reduced hospital stay (5 vs 8 days, p=0.002), and lower wound infection rates (5% vs 15%). However, recurrence was higher in Group A (10% vs 2.5%, p=0.04). Surgical removal demonstrated lower recurrence but increased intraoperative morbidity, including bleeding (5%) and ileus (7.5%). Mortality was nil in both groups.

Conclusion: Percutaneous drainage is a safe and effective first-line option for appendicular mass, offering reduced hospital stay and morbidity. Surgical removal provides definitive treatment with lower recurrence but higher perioperative risk. Patient selection should guide management, balancing safety and long-term outcomes.