急性阑尾炎是各种常见急腹症的病因之一，既往针对急性阑尾炎，临床主要治疗方案为阑尾切除术。但随着人们对阑尾功能的研究愈发深入，以及考虑到外科手术治疗方案的遗留手术瘢痕等问题，在内镜技术的飞速发展下，2012年在刘冰熔教授团队的首创下，内镜下逆行阑尾炎治疗术（ERAT）应运而生。经过十余年发展，ERAT技术已十分成熟，可用来治疗包括阑尾周围脓肿、阑尾粪石嵌顿等各种类型的急性阑尾炎，并且随着目前内镜直视化阑尾炎治疗术（D-ERAT）的成熟，提高了手术成功率及安全性，大大减少患者及医护人员的受辐射量，并解决了孕妇等特殊患者无法行ERAT的难题。本文通过简述ERAT的历史发展，探讨D-ERAT的创新治疗思路，并展望D-ERAT的未来前景。

Acute appendicitis is one of the common causes of acute abdominal pain. In the past, the main clinical treatment for acute appendicitis was appendectomy. However, with deeper research in the function of appendix and considering issues such as residual surgical scars from surgical procedures, along with the rapid development of endoscopic technology, endoscopic retrograde appendicitis therapy (ERAT) was pioneered in 2012 by Professor Liu Bingrong's team. After more than a decade of development, ERAT technology has become quite mature and can be used to treat various types of acute appendicitis, including peri-appendiceal abscesses and appendiceal fecalith impactions. Moreover, with the advent of currently direct endoscopic retrograde appendicitis therapy（D-ERAT）, the success rate and safety of the procedure have improved, significantly reducing radiation exposure to patients and medical staff, and addressing the difficulty of performing ERAT in special patient populations such as pregnant women. This article briefly reviews the historical development of the ERAT procedure, explores the innovative treatment approach of D-ERAT, and looks forward to the future prospects of D-ERAT.