Palavras-chave
Tratamento conservador
Antibacterianos
Apendicectomia
Guia de prática clínica
Como Citar
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Resumo
Objetivo: Analisar as evidências atuais sobre o manejo conservador da apendicite aguda não complicada, considerando eficácia, segurança, recorrência, critérios de seleção, populações específicas e aplicabilidade clínica dessa estratégia. Revisão bibliográfica: Evidências recentes indicam sucesso do manejo não operatório entre 63% e 66% em um ano, embora apresente menor eficácia global que o tratamento cirúrgico. A seleção adequada de candidatos deve considerar confirmação diagnóstica por imagem, estabilidade clínica, ausência de peritonite ou sepse, presença de apendicolito, possibilidade de seguimento e decisão compartilhada, conforme diretrizes WSES Jerusalém 2025. A recorrência permanece uma limitação relevante, e populações como idosos, gestantes e crianças requerem cautela adicional devido à menor disponibilidade de evidências específicas. Estudos econômicos apresentam resultados variáveis conforme o sistema de saúde analisado. Considerações finais: O manejo conservador constitui alternativa viável à apendicectomia em pacientes selecionados, desde que sejam considerados risco de falha, recorrência, preferências individuais e acesso rápido à cirurgia em casos de evolução desfavorável.
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