title: Routine interval appendectomy in children is not indicated.
abstract: BACKGROUND
  This study evaluates outcomes for children treated without interval appendectomy (IA) after successful nonoperative management of perforated appendicitis.
  
  
  METHODS
  A retrospective study of pediatric patients with appendicitis was performed from 12 regional acute-care hospitals from 1992 to 2004 with mean length of follow-up of 7.5 years. Main outcomes were recurrent appendicitis and cumulative length of hospital stay.
  
  
  RESULTS
  The study included 6439 patients, of which 6367 (99%) underwent initial appendectomy. Seventy-two (1%) patients were initially managed nonoperatively and 11 patients had IA. Of the remaining 61 patients without IA, 5 (8%) developed recurrent appendicitis. Age, sex, type of appendicitis, and abscess drainage had no influence on recurrent appendicitis. Cumulative length of hospital stay was 6.6 days in patients without IA, 8.5 days in patients with IA, and 9.6 days in patients with recurrent appendicitis.
  
  
  CONCLUSIONS
  Recurrent appendicitis is rare in pediatric patients after successful nonoperative management of perforated appendicitis. Routine IA is not necessarily indicated for these children.
authors.affiliation: Division of Pediatric Surgery and Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA 90027, USA.
authors.forename: Devin
authors.initials: D
authors.lastname: Puapong
authors.forename: Steven L
authors.initials: SL
authors.lastname: Lee
authors.forename: Philip I
authors.initials: PI
authors.lastname: Haigh
authors.forename: Anna
authors.initials: A
authors.lastname: Kaminski
authors.forename: In-Lu Amy
authors.initials: IL
authors.lastname: Liu
authors.forename: Harry
authors.initials: H
authors.lastname: Applebaum
mesh_terms: D000293:Adolescent; D001062:Appendectomy; D001064:Appendicitis / Q000601:surgery* / Q000628:therapy; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence