P461 Rapid Response to Appendectomy in the Majority of Patients with Refractory Ulcerative Colitis

Abstract Background Appendectomy is suggested to improve the course of the disease in many patients with refractory Ulcerative Colitis (UC). Present prospective observational study demonstrates short-term outcomes after an appendectomy in 16 patients with refractory UC. Methods Between 5/2022 and 11/2022, 16 selected patients underwent appendectomy for refractory UC. Only patients with dysplasia or cancer were excluded. However, an appendectomy was not proposed to patients with severe sarcopenia or severe anemia, except in one case of severe acute colitis. The appendectomy was performed without the removal of the cecal base. Results Mean age was 35 years (18 to 59 years), there were 9 male patients. Nine had a pancolitis. Eight patients were referred to colectomy (50%). Eight were taking steroids (10mg to 75mg), all but three were under biological treatment. Median preoperative Mayo score was 6.5. Two patients had severe anemia (hemoglobin <10 g/dl). The appendix appeared to be inflamed visually in 3 patients (19%) and histologically in 10 patients (62%). Hospital stay was median 2 days, there was one wound infection at the port site. A significant improvement of disease symptoms was reported by 14 patients during the first 2 weeks. At the end of the follow-up period of 1 to 6 months, no colectomy has been performed. Conclusion The majority of patients with refractory UC demonstrates rapid clinical response to an appendectomy. Longer observation is necessary in order to determine whether the rapid response translates to a favourable long-term outcome.