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In the past, appendicitis usually meant a patient had to undergo surgery. But doctors are now steering away from the traditional appendectomy and more toward anti-inflammatory drugs, according to a survey by the Health and Welfare Ministry.

Appendectomies carried out at hospitals and clinics in September 1996 dropped 37 percent from the corresponding number in September 1990, the survey shows. “In the past, surgeons immediately carried out appendectomies when they found patients were suffering from appendicitis. But these days, they alleviate the inflammation through the use of drugs. Thus, there are an increasing number of cases in which an appendectomy is not carried out,” said one surgeon who has performed the operation.

The ministry tallies the number of appendectomies every third year. The survey began monitoring the operation at clinics with 19 or fewer beds in 1984, and at hospitals with 20 or more beds in 1990. In September 1996, these medical institutions performed 10,024 appendectomies, about a 37 percent decrease from the 15,978 appendectomies carried out in September 1990. Of the 1996 total, only 891 appendectomies were performed at clinics — about one-sixth the 5,352 in 1984.

There are two types of appendicitis — acute and chronic. Both types are caused by closure of the appendiceal cavity, often due to virus infection. The interference of foreign substances can also lead to such closure.

“Because antibiotics are so routinely used to alleviate inflammations caused by other diseases, there are cases in which appendicitis is cured by the antibiotics without doctors noticing it,” said Toshihiko Ogane, a surgeon and vice director of Higashi Washimiya Hospital in Washimiya, Saitama Prefecture.

“In addition, a recognition has emerged among surgeons that because the appendiceal may be useful for the body’s immunity system, it may be better to avoid an appendectomy in many cases,” he added.

Ogane has written a book on the subject titled “Geka-i to Mocho” (“Surgeons and the Appendiceal”), printed by Iwanami Publishers.


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