Time to Surgery Does Not Impact Outcome in Pediatric Appendicitis.

Area of Science:

• Pediatric Surgery
• Gastroenterology

Background:

• Acute appendicitis is common in children, leading to significant healthcare resource use.
• Optimal timing for appendectomy in pediatric cases remains debated.

Purpose of the Study:

• To investigate the link between time to appendectomy and patient outcomes in children.
• To evaluate the safety and feasibility of delayed appendectomy in pediatric acute appendicitis.

Main Methods:

• Retrospective analysis of 852 children under 14 undergoing appendectomy for suspected appendicitis.
• Patients were divided into early (<=8 hours) and delayed (>8 hours) appendectomy groups.
• Comparison of demographic, clinical, radiographic, peri-operative data, and outcomes between groups.

Main Results:

• No significant differences were observed in complicated appendicitis rates, post-operative complications, hospital stay duration, or 30-day readmission rates between early and delayed appendectomy groups.
• The study included 544 patients in the early group and 308 in the delayed group.
• The analysis covered an eight-year period.

Conclusions:

• Delayed appendectomy within 24 hours is a safe and feasible option for pediatric acute appendicitis.
• Conservative management with antibiotics may be suitable for initial treatment, particularly for nighttime presentations, enabling delayed surgery.
• This strategy can optimize surgical scheduling and resource allocation.