LAMA: Laparoscopy or antibiotics for appendicitis. Version 1.0
Research type
Research Study
Full title
The LAMA study: Laparoscopy or Antibiotics for Managing Appendicitis. Why is conservative management of acute appendicitis underused? A mixed methods study.
IRAS ID
294552
Contact name
Eleanor M Massie
Contact email
Sponsor organisation
NHS Golden Jubilee
Duration of Study in the UK
1 years, 11 months, 25 days
Research summary
Acute appendicitis is the commonest surgical emergency worldwide. In the U.K., keyhole surgery to remove the appendix is performed in almost all cases, with a smaller number of patients treated using antibiotics alone (called conservative management). This is despite evidence stating that conservative management is effective for many patients. During the COVID-19 pandemic, it was recommended by leading surgical associations to avoid surgery and to consider conservative management first in acute appendicitis. This was because of the concern of keyhole surgery being aerosol generating putting patients and staff at risk of viral exposure. When surgery was confirmed as safe and subsequently re-started, surgeons returned to performing surgery as the main treatment, despite up-to-date evidence reporting during the pandemic that conservative management was effective and safe. Using interviews and surveys we will investigate patients’ and surgeons’ attitudes and opinions regarding conservative management in acute appendicitis. We will explore reasons which would encourage surgeons, or stop them, from offering conservative management and attempt to understand why patients would potentially prefer surgery over conservative management. We will perform a cost-effectiveness analysis of acute appendicitis options to see which provides best value for money for the NHS and patients. We also aim to produce and implement acute appendicitis guidelines that embrace shared-decision making. Finally, implementation research is an overlooked area in surgery, and we hope to produce a template that can be applied in future implementation research.
REC name
North East - Newcastle & North Tyneside 1 Research Ethics Committee
REC reference
22/NE/0102
Date of REC Opinion
26 Jun 2022
REC opinion
Favourable Opinion