• Mauro Podda, Fernando Serventi, Lorenzo Mortola, Stefano Marini, Danilo Sirigu, Michela Piga, Marcello Pisano, Massimiliano Coppola, Ferdinando Agresta, Francesco Virdis, Salomone Di Saverio, Nicola Cillara, and ACTUAA Study Collaborative Working Group.
• General, Minimally Invasive and Robotic Surgery Unit, San Francesco Hospital, Via Mannironi 1, 08100, Nuoro, Italy. mauropodda@ymail.com.
• Int J Colorectal Dis. 2017 Nov 1; 32 (11): 1649-1660.

PurposeAcute appendicitis (AA) is among the most common causes of lower abdominal pain and admissions to the emergency department. Over the past 20 years, there has been a renewed interest in the conservative management of uncomplicated AA, and several studies demonstrated that an antibiotic-first strategy is a viable treatment option for uncomplicated AA. The aim of this prospective non-randomized controlled, multicenter trial is to compare antibiotic therapy and emergency appendectomy as treatment for patients with uncomplicated AA confirmed by US and/or CT or MRI scan.MethodsAll adult patients in the age range 18 to 65 years with suspected AA, consecutively admitted to the Surgical Department of the 13 participating Italian Hospitals, will be invited to take part in the study. A multicenter prospective collected registry developed by surgeons, radiologists, and pathologists with expertise in the diagnosis and treatment of uncomplicated acute appendicitis represents the best research method to assess the long-term role of antibiotics in the management of the disease. Comparison will be made between surgical and antibiotic-first approaches to uncomplicated AA through the analysis of the primary outcome measure of complication-free treatment success rate based on 1-year follow-up. Quality of life, length of hospital stay, pain evaluation, and time to return to normal activity will be evaluated as secondary outcome measures.Trial RegistrationClinicaltrials.gov ID: NCT03080103.

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