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NCT Number: NCT07837531

Immediate Laparoscopic Appendectomy Versus Interval Laparoscopic Appendectomy for Early Appendicular Mass

This study compares two standard treatment approaches for patients presenting with an appendicular mass, an inflammatory lump that forms when the appendix becomes severely inflamed and walled off by surrounding abdominal tissues.

The traditional treatment involves conservative medical therapy using intravenous antibiotics followed by an elective interval surgery to remove the appendix 6 to 8 weeks later. Alternatively, advances in minimally invasive surgery allow for an immediate keyhole operation (laparoscopic appendectomy) performed during the initial hospital admission. The goal of this study is to evaluate which approach leads to shorter total hospital stays, faster recovery, and fewer complications.

Participants will be assigned to one of two treatment groups:

* Group A (Immediate Laparoscopic Appendectomy): Participants undergo laparoscopic surgery to remove the appendix within 24 hours of hospital admission. * Group B (Interval Laparoscopic Appendectomy): Participants receive initial intravenous antibiotics in the hospital until symptoms resolve. After discharge, they return 6 to 8 weeks later for elective laparoscopic surgery.

Participants in both groups will be monitored throughout their hospital stay and will attend follow-up visits at 1, 3, and 6 months postoperatively to assess recovery, wound healing, and any potential complications.

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Key information

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adults aged 18 years or older
  • Clinical diagnosis of appendicular mass confirmed by abdominal ultrasonography and/or abdominal CT scan
  • Presentation within 72 hours of symptom onset
  • Provision of written informed consent

Exclusion criteria

  • Generalized peritonitis or perforation with free intraperitoneal air
  • Appendicular abscess > 5 cm not amenable to percutaneous drainage
  • History of previous abdominal surgeries (contraindication to laparoscopy)
  • American Society of Anesthesiologists (ASA) physical status classification ≥ IV
  • Severe shock or sepsis requiring preoperative intensive care unit (ICU) admission
  • Suspected cecal malignancy or colonic neoplasm
  • Pregnancy

Treatment and study plan

Immediate Laparoscopic Appendectomy

Procedure

Laparoscopic appendectomy performed within 24 hours of admission. The procedure is executed using a standard 3-port technique (one 10 mm umbilical camera port and two 5 mm working ports). It includes careful blunt and sharp adhesiolysis to identify and mobilize the appendix, appendectomy using an endoloop ligature or endoscopic stapler, peritoneal lavage with 3-5 liters of warm normal saline, and abdominal drain placement when clinically indicated.

Interval Laparoscopic Appendectomy

Procedure

Initial conservative medical management with intravenous antibiotics (third-generation cephalosporin, metronidazole, and amikacin) and analgesics, monitored clinically and via ultrasonography every 48 hours until clinical improvement and discharge. Patients undergo elective interval laparoscopic appendectomy 6 to 8 weeks later using the standard 3-port laparoscopic technique.

Primary outcomes

  1. Total Length of Hospital Stay

    Time frame: Up to 3 months

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Sponsors and collaborators

Lead sponsor

Assiut University

Other

Registry information

Official study title

Immediate Laparoscopic Appendectomy Versus Interval Laparoscopic Appendectomy for Early Appendicular Mass: A Comparative Study

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Sep 23, 2026
Registry last updated
Sep 23, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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