Review
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2017; 23(32): 5849-5859
Published online Aug 28, 2017. doi: 10.3748/wjg.v23.i32.5849
Laparoscopic appendectomy for acute appendicitis: How to discourage surgeons using inadequate therapy
Tomohide Hori, Takafumi Machimoto, Yoshio Kadokawa, Toshiyuki Hata, Tatsuo Ito, Shigeru Kato, Daiki Yasukawa, Yuki Aisu, Yusuke Kimura, Maho Sasaki, Yuichi Takamatsu, Taku Kitano, Shigeo Hisamori, Tsunehiro Yoshimura
Tomohide Hori, Takafumi Machimoto, Yoshio Kadokawa, Toshiyuki Hata, Tatsuo Ito, Shigeru Kato, Daiki Yasukawa, Yuki Aisu, Yusuke Kimura, Maho Sasaki, Yuichi Takamatsu, Taku Kitano, Shigeo Hisamori, Tsunehiro Yoshimura, Department of Gastrointestinal Surgery, Tenriyorodusoudanjyo Hospital, Tenri, Nara 632-8552, Japan
Author contributions: Hori T drew all of the schemas, collected the data, and wrote this review; Machimoto T, Kadokawa Y, Hata T, Ito T, Kato S, Yasukawa D, Aisu Y, Kimura Y, Sasaki M, Takamatsu Y, Kitano T and Hisamori S provided academic opinions on the review and helped to assess important papers; Yoshimura T supervised this review.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tomohide Hori, PhD, MD, FACS, Department of Gastrointestinal Surgery, Tenriyorodusoudanjyo Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan. horitomo@tenriyorozu.jp
Telephone: +81-743-635611 Fax: +81-743-631530
Received: May 12, 2017
Peer-review started: May 16, 2017
First decision: June 5, 2017
Revised: July 25, 2017
Accepted: August 1, 2017
Article in press: August 2, 2017
Published online: August 28, 2017
Core Tip

Core tip: Acute appendicitis develops in a progressive and irreversible manner, and emergent laparoscopic appendectomy (LA) is mandatory. The Japanese government uses a universal health insurance system. Any physician and institution can routinely perform expensive emergent LA in Japan, in accordance with medical ethics. Unsafe, but cost-effective, treatments such as interval/delayed appendectomy and conservative management only are unsuitable in Japan. Time-honored practices, (i.e., emergent LA) should be respected in Japan.