[Delayed appendectomy in the pediatric patient. How safe is it?]

Area of Science:

• Pediatric Surgery
• Gastrointestinal Surgery

Background:

• Delayed appendectomy is a viable option in centers lacking immediate pediatric surgical availability.
• Uncomplicated appendicitis in children requires careful management to optimize outcomes.

Purpose of the Study:

• To compare outcomes of immediate versus delayed appendectomy in pediatric patients with uncomplicated appendicitis.
• To evaluate the impact of delayed surgery on length of stay and complication rates.

Main Methods:

• An analytical quasi-experimental study involving 45 pediatric patients (6-14 years) with uncomplicated appendicitis.
• Comparison of outcomes between immediate surgery and delayed surgery (average 21 hours post-diagnosis).
• Analysis of length of stay, postoperative complications, and factors associated with gangrenous appendicitis.

Main Results:

• No significant differences in mean length of stay or complication rates were observed between immediate and delayed surgery groups.
• Appendicolith presence was associated with an increased probability of gangrenous appendicitis.
• Delayed surgery group (ADif) included 24 patients, immediate surgery group (AIn) included 21 patients.

Conclusions:

• Delaying appendectomy for selected pediatric cases of uncomplicated appendicitis is safe, with no significant increase in hospital stay or complications.
• Appropriate patient selection for delayed appendectomy can help avoid unnecessary referrals, reducing family stress and healthcare system burden.