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Appendectomy does not reduce risk for colectomy in patients with UC
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Appendectomy was not associated with a reduced risk for requiring colectomy in patients with ulcerative colitis, and may even increase the risk if performed after ulcerative colitis diagnosis, according to the results of a large cohort study and meta-analysis.
“Since the appendix may play a role in modulating the development and disease course of UC, further investigation is needed to determine the effects appendectomy may have on UC disease course,” Dermot P. McGovern, MD, PhD, of the division of gastroenterology at Cedars-Sinai Medical Center in Los Angeles, and colleagues wrote.
Dermot P. McGovern
Researchers used the National Institute of Diabetes and Digestive and Kidney Diseases Inflammatory Bowel Disease Genetics Consortium database to identify 2,980 patients diagnosed with UC from January 2003 through November 2013, and compared the risk for colectomy between patients who did and did not undergo appendectomy. Of the 2,714 patients with complete data, 111 (4.4%) had an appendectomy, 63 of which were performed before UC was diagnosed.
Multivariate analysis showed appendectomy performed at any time was an independent risk factor for colectomy (OR = 1.87; 95% CI, 1.12-3.14), whereas appendectomy performed after UC was diagnosed showed the strongest association with colectomy (OR = 2.22; 95% CI, 1.1-4.49).
The researchers also performed a meta-analysis of eight studies, including their own, which confirmed that appendectomy, either performed before or after UC diagnosis, had no effect on colectomy rates.
“In conclusion, in this large observational study with an updated meta-analysis, we found that appendectomy performed at any time in relation to UC diagnosis was not associated with a decrease in severity of disease,” the researchers wrote. “In fact, appendectomy after UC diagnosis may be associated with a higher risk of colectomy. Therefore, based on current observational data, appendectomy as a treatment for UC is not recommended.”
A prospective study of appendectomy’s effects on the clinical course of UC is currently underway, they added. – by Adam Leitenberger
Disclosure: One of the researchers reports she served on the advisory board for and received honoraria from Janssen, AbbVie and Takeda, and also received grant support from AbbVie.
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