New alternative appendicitis therapy (no surgery, no antibiotics) - ERAT method

TL;DR: Traditionally treated with surgery, appendicitis now has a non-surgical alternative in China called ERAT, developed by Professor Liu Bingrong, which uses endoscopy to treat the condition without removing the appendix, effectively treating thousands of patients with minimal complications. Although this method has yet to catch on in other countries.

Background: For over a century, appendicitis treatment centered on surgical removal of the appendix, or appendectomy, which became the gold standard after its introduction in the late 1800s. Initially performed as an open surgery, this was later refined into a less invasive laparoscopic method in the 1980s, reducing recovery time and complications. In recent years, however, some western countries began exploring non-surgical options using antibiotics, which can successfully treat uncomplicated cases but come with higher recurrence rates.

Alternative approach: "In 2010, inspired by the endoscopic treatment of suppurative cholangitis, Professor Liu Bingrong innovatively proposed a new method for the treatment of appendicitis, which was named Endoscopic Retrograde Appendicitis Therapy (ERAT). This method does not require laparotomy or appendectomy, but achieves the purpose of treating appendicitis by addressing the cause of acute appendicitis, while completely preserving the appendix and its functions. In 2011 and 2013, Professor Liu Bingrong introduced ERAT at the Digestive Disease Week (DDW) and published a total of 8 articles in various journals. After nearly 10 years of development, ERAT has made progress in technological advancements, changes in indications, and clinical significance.

Since December 16, 2009, when the world's first case of ERAT was completed at the Digestive Endoscopy Center of the Second Hospital of Harbin Medical University, to 2019, the ERAT technique has been in existence for 10 years. According to incomplete statistics from 2021, ERAT has been carried out in 32 provinces, municipalities, and autonomous regions in China, treating over 3,200 patients without any serious complications."

EndoNews. (2024). Endoscopic retrograde appendicitis therapy (ERAT) [Video]. YouTube

2022 - Endoscopic retrograde appendicitis therapy for acute appendicitis: a systematic review and meta-analysis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286766/