Who should not undergo appendectomy surgery

Nov 05, 2025 Source: Cainiu Health

Dr. Wang Lei

Introduction

Groups unsuitable for appendectomy mainly include individuals with severe cardiopulmonary diseases, those in an active phase of specific infections, patients with coagulation disorders, those with advanced malignant tumors, and elderly individuals who are extremely frail. These individuals should receive standardized conservative treatment under medical supervision, such as using antibiotics to control inflammation and intravenous fluid therapy to maintain electrolyte balance.

Generally, individuals unsuitable for appendectomy mainly include those with severe cardiopulmonary diseases, those in a special infectious phase, those with coagulation disorders, patients with advanced malignant tumors, and elderly individuals who are extremely frail. The detailed analysis is as follows:

1. Individuals with severe cardiopulmonary diseases: Patients suffering from severe heart failure, acute myocardial infarction, severe pneumonia, or respiratory failure may not tolerate the trauma of surgery and anesthesia stimulation. Life-threatening events such as cardiac arrest or respiratory failure may occur during the operation.

2. Individuals in a special infectious phase: When a patient is experiencing systemic severe infections such as sepsis or bacteremia, or has an acute infection near the surgical site, surgery could lead to the spread of infection and worsen the condition. Systemic infection should first be controlled, and surgery considered only after the infection stabilizes.

3. Individuals with coagulation disorders: Patients with hemophilia, severe liver disease, or those taking long-term anticoagulant medications that cannot be discontinued have abnormal clotting functions. They are at high risk of uncontrollable bleeding during surgery and poor wound healing afterward, making them generally unsuitable candidates for appendectomy.

4. Patients with advanced malignant tumors: In patients with advanced cancer, bodily functions are severely compromised and immunity is extremely low. Surgical trauma may further weaken resistance, leading to difficult postoperative recovery and potentially triggering other complications.

5. Elderly individuals who are extremely frail: Patients over 80 years old, especially those with multiple chronic conditions, long-term bedridden status, and extreme physical weakness, have poor tolerance to surgery. They face a high risk of postoperative complications such as pulmonary infections and thrombosis. Conservative treatment is usually preferred, with surgery considered only if conservative management fails.

Individuals unsuitable for appendectomy should receive standardized conservative treatment under medical guidance, including antibiotic use to control inflammation and intravenous fluid therapy to maintain electrolyte balance.

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Where is the incision site for minimally invasive appendectomy?

The incisions for minimally invasive appendectomy are typically located in the abdomen, usually three in number—situated at the umbilicus and on both sides of the lower abdomen or near the midline of the lower abdomen. Each incision is small, generally 0.5–1 cm in length, and their exact positions may be slightly adjusted depending on the patient's condition. If redness, swelling, fluid discharge, or persistent pain occurs at the incision site after surgery, prompt medical attention is recommended.

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What are the complications of appendectomy surgery?

In general, as a common treatment for appendicitis, appendectomy may lead to complications including wound infection, intra-abdominal hemorrhage, intra-abdominal abscess, intestinal adhesions, and residual appendicitis. After surgery, patients should follow medical advice for wound care, engage in early appropriate activity to reduce the risk of intestinal adhesions, and closely monitor body temperature, abdominal pain, and bowel movements.

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What are the complications after appendectomy?

In general, although appendectomy is a common surgical procedure, it may still lead to certain postoperative complications, including incision infection or pain, intestinal adhesions, stump appendicitis, pelvic abscess, and gastrointestinal dysfunction. After surgery, patients should pay attention to wound care, get out of bed and move as early as possible to reduce the risk of intestinal adhesions, and maintain a light diet, avoiding overeating and binge eating.

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Does getting anesthesia hurt during appendicitis surgery?

In general, whether anesthesia for appendectomy causes pain depends on the type of anesthesia used. Local anesthesia may cause mild discomfort, while general anesthesia usually involves no significant pain. After surgery, it is important to keep the incision clean and dry to prevent infection. Initially, patients should eat light and easily digestible foods, gradually returning to a normal diet. Appropriate physical activity can be resumed according to individual recovery progress.