Clinical Effectiveness and Safety Evaluation of SpyGlass Versus X-Ray-Assisted ERAT in the Treatment of Acute and Chronic Appendicitis.

BACKGROUND AND STUDY AIM: To evaluate the clinical effectiveness and safety of SpyGlass versus X-ray-assisted endoscopic retrograde appendicitis therapy (ERAT) in the treatment of acute and chronic appendicitis. PATIENTS AND METHODS: A retrospective analysis was conducted on 153 patients with acute, subacute, and chronic appendicitis admitted to the Endoscopy Center of the First Affiliated Hospital with Nanjing Medical University between June 2022 and July 2024. According to the different endoscopic methods, the patients were divided into the X-ray group and the SpyGlass group. The treatment success rate, procedure duration, VAS pain scores before and after surgery, length of hospital stay, time to resume diet, hospitalization costs, complications, and 12-month recurrence were analyzed, respectively. RESULTS: Baseline clinical characteristics showed no intergroup differences. Compared with the X-ray assisted group, the SpyGlass group achieved higher treatment success, shorter operation and fasting recovery time, and lower 12-month recurrence, while the X-ray group had lower hospitalization costs. Hospital stay length and 6-h postoperative VAS reduction were comparable between groups. Univariate and multivariate logistic regression identified no independent risk factors for procedural success; Cox regression for recurrence revealed migrated abdominal pain and appendicolith as independent risk factors. CONCLUSION: Both SpyGlass and X-ray assisted ERAT are safe and effective for the treatment of acute and chronic appendicitis. However, patients in the SpyGlass group demonstrated superior procedural success alongside reduced long-term recurrence. Overall, ERAT represents an optimal minimally invasive, non-surgical approach for the clinical management of acute and chronic appendicitis.