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Can Physicians Delay Appendectomy for One Night in Children With Acute Appendicitis?
Amrollah Salimi1, Seyed Mojtaba Alavi2, Mojdeh Bahadorzadeh1
1Department of Surgery, School of Medicine, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran.
Insights
Delaying appendectomy for up to 18 hours in children with appendicitis is safe. This study found no increased risk of complications like appendix rupture or surgical site infections with delayed surgery.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Appendicitis is a leading cause of emergency surgery in children.
- Immediate appendectomy has been standard, but its necessity is debated.
- Diagnostic challenges exist in pediatric appendicitis.
Purpose of the Study:
- To evaluate the safety of delaying appendectomy in pediatric acute appendicitis.
- To determine if a delay of up to 18 hours increases complication risks.
Main Methods:
- Retrospective analysis of 534 pediatric acute appendicitis cases.
- Comparison of immediate (within 8 hours) vs. delayed (8-18 hours) appendectomy groups.
- Assessment of demographic data, symptoms, lab results, and complications.
Main Results:
- No significant difference in surgical site infection rates (2.8% vs 4.2%).
- No significant difference in perforation risk between groups (21.9% vs 19.8%).
Conclusions:
- Delaying appendectomy for up to 18 hours is safe in pediatric patients.
- No increased risk of perforation or surgical site infection observed with delayed surgery.
Background:
In pediatrics, appendicitis is the leading cause of emergency surgery. It was previously believed that postponing the surgery could lead to the appendix rupture. Children with this condition can be difficult to diagnose. The evidence regarding the necessity of an immediate appendectomy is a topic of debate. In this study, we evaluated the medical records of patients who were diagnosed with acute appendicitis to determine whether postponing appendectomy for one night is safe or not.
Methods:
This study involved 534 individuals diagnosed with acute appendicitis, who were separated into two groups: those who underwent an appendectomy immediately (within 8 hours) and those who had a delayed procedure (between 8-18 hours). We recorded and compared demographic data, symptoms, laboratory results, time of symptoms, hospitalization duration, surgery duration, overall time, length of stay after surgery, and any other complications that occurred between the two groups.
Results:
The rate of surgical site infection (SSI) did not differ significantly between the groups (2.8% vs 4.2%, P=0.74). Additionally, there was no significant difference in the risk of perforation between the time of surgery in our study (21.9% vs 19.8%, P>0.05).
Conclusion:
Our findings suggest that there is no increased risk of complications such as perforation when appendectomy is delayed for up to 18 hours.
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