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Published on: February 28, 2025

Elective interval appendectomy following non-operative management for uncomplicated acute appendicitis: a feasible

Ryoichi Abiko1,2, Hiroki Goto3,4, Ayaka Fukada3,4

  • 1Department of Pediatric Surgery, Toyama Prefectural Central Hospital, 2-2-78 Nishinagae, Toyama, 930-8550, Japan. r.abiko.tn@juntendo.ac.jp.

Pediatric Surgery International
|July 3, 2026
PubMed

Insights

Elective interval appendectomy after non-operative management for pediatric appendicitis is safe and feasible, with high success rates for same-day discharge. This approach offers a potential new treatment strategy for uncomplicated acute appendicitis.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Clinical Outcomes Research

Background:

  • Predicting recurrence after non-operative management (NOM) for pediatric uncomplicated acute appendicitis (UCAA) remains challenging.
  • This uncertainty causes significant anxiety for patients and families.
  • Elective interval appendectomy (E-IA) is an option, with same-day discharge (SDD) being a focus for improved efficiency.

Purpose of the Study:

  • To evaluate the safety and feasibility of elective interval appendectomy (E-IA) following non-operative management (NOM) for pediatric uncomplicated acute appendicitis (UCAA).
  • To assess the outcomes of same-day discharge (SDD) in patients undergoing E-IA.
  • To analyze patient/family and staff satisfaction with the E-IA process.

Main Methods:

  • Retrospective review of patients aged 18 years or younger who underwent laparoscopic E-IA after successful NOM for UCAA (2017-2025).
  • UCAA defined by ultrasound grade I/IIa appendicitis without complications (perforation, abscess, peritonitis).
  • Analysis of patient demographics, perioperative outcomes, histopathology, and satisfaction surveys.

Main Results:

  • 120 patients underwent E-IA; 40 were discharged the same day.
  • Low complication rate (2.5%), with 97.5% SDD success.
  • Recurrence before E-IA occurred in 4.2% of patients, all managed successfully with repeat NOM.
  • High patient/family (83.3%) and staff (89.3%) satisfaction.
  • Histopathology confirmed inflammatory or reparative changes, with no normal specimens.

Conclusions:

  • Elective interval appendectomy following NOM for UCAA demonstrates low morbidity.
  • Same-day discharge is a feasible and successful approach for E-IA in this cohort.
  • This strategy represents a potentially novel treatment concept for UCAA, addressing recurrence concerns.
Abstract

Keywords:
ChildrenInterval appendectomyNon-operative managementSame-day dischargeUncomplicated acute appendicitis

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