Tuesday, March 13, 2018

The appendectomy in history (subtitle: now is a pretty good time to be alive)

Via Dr Beachcombing's site, this link discusses briefly the history of the appendectomy:
In 1735, Dr. Claudius Amyand performed the world’s first successful appendectomy, at St. George’s Hospital in London. The patient was an 11-year old boy whose appendix had become perforated by a pin he had swallowed. The first successful operation to treat acute appendicitis was performed soon after, in 1759 in Bordeaux.  General anesthesia was not available until 1846, so these operations required many assistants to restrain patients during what were undoubtedly very painful procedures.

Surgical treatment for appendicitis began in earnest during the 1880s. Although doctors struggled to decide who should undergo the knife – some patients would recover on their own without surgery – surgical technique and anesthesia had improved outcomes to such an extent that surgery would rapidly became the gold standard approach. By the end of the 20th century, laparoscopic surgery replaced open surgery in most cases, and laparoscopic appendectomy is now considered one of the safest, lowest-complication surgical procedures performed today.
I didn't know that it could often be successfully treated with antibiotics:
More recently, researchers are revisiting the question of whether antibiotics are just as effective as surgery for treatment for acute appendicitis. In the 1940s and 1950s, doctors in England began treating patients with antibiotics – with excellent results. During the Cold War, men on submarines received antibiotics instead of an appendectomy, as the submarines could not surface for six months or more, and patients reportedly did well with this approach.  And five recent European studies reported findings consistent with those anecdotes: 70% of patients recovered using antibiotics rather than surgery in these studies. In light of this evidence, a new study in California will attempt to verify whether antibiotics may be as good as surgery and offer a less invasive approach to the treatment of appendicitis.


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