title: Quality of life assessment between laparoscopic appendectomy at presentation and interval appendectomy for perforated appendicitis with abscess: analysis of a prospective randomized trial.
abstract: OBJECTIVE
  The current study examined the impact of immediate laparoscopic surgery vs nonoperative initial management followed by interval appendectomy for appendicitis with abscess on child and family psychosocial well-being.
  
  
  METHODS
  After obtaining Internal Review Board approval, 40 patients presenting with a perforated appendicitis and a well-formed abscess were randomized to surgical condition. Parents were asked to complete child quality of life and parenting stress ratings at presentation, at 2 weeks postadmission, and at approximately 12 weeks postadmission (2 weeks postoperation for the interval appendectomy group).
  
  
  RESULTS
  Children in the interval arm experienced trends toward poorer quality of life at 2 and 12 weeks postadmission. However, no group differences in parenting stress were observed at 2 weeks postoperation. At 12 weeks postadmission, participants in the interval condition demonstrated significant impairment in both frequency and difficulty of problems contributing to parenting distress.
  
  
  CONCLUSIONS
  Families experience significant parenting distress related to the child's functioning and disruption in the child's quality of life that may be because of the delay in fully resolving the child's medical condition. In addition, parents experience negative consequences to their own stress as a result of the delay before the child's appendectomy.
authors.affiliation: Section of Developmental and Behavioral Sciences, The Children's Mercy Hospital, Kansas City, MO 64108, USA.
authors.forename: Jennifer V
authors.initials: JV
authors.lastname: Schurman
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Cushing
authors.forename: Carissa L
authors.initials: CL
authors.lastname: Garey
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Laituri
authors.forename: Shawn D
authors.initials: SD
authors.lastname: St Peter
mesh_terms: D018784:Abdominal Abscess / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D001064:Appendicitis / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D002648:Child; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents