title: Role of non-operative management in pediatric appendicitis.
abstract: Appendectomy is currently considered the standard of care for children with acute appendicitis. Although commonly performed and considered a safe procedure, appendectomy is not without complications. Non-operative management has a role in the treatment of both uncomplicated and complicated appendicitis. In uncomplicated appendicitis, initial non-operative management appears to be safe, with an approximate 1-year success rate of 75%. Compared to surgery, non-operative management is associated with less disability and lower costs, with no increase in the rate of complicated appendicitis. In patients with complicated appendicitis, initial non-operative management with interval appendectomy has been shown to be safe with reported success rates between 66% and 95%. Several studies suggest that initial non-operative management with interval appendectomy may be beneficial in patients with perforated appendicitis with a well-formed abscess or inflammatory mass. Recent data suggest that interval appendectomy may not be necessary after initial non-operative management of complicated appendicitis.
authors: Center for Surgical Outcomes Research, The Research Institute, Nationwide Childrens Hospital, Columbus, Ohio; Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
authors: Dani O
authors: DO
authors: Gonzalez
authors: Center for Surgical Outcomes Research, The Research Institute, Nationwide Childrens Hospital, Columbus, Ohio; Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Dr, Columbus, Ohio 43205.
authors: Katherine J
authors: KJ
authors: Deans
authors: Center for Surgical Outcomes Research, The Research Institute, Nationwide Childrens Hospital, Columbus, Ohio; Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Dr, Columbus, Ohio 43205. Electronic address: Peter.Minneci@nationwidechildrens.org.
authors: Peter C
authors: PC
authors: Minneci
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001062:Appendectomy; D001064:Appendicitis / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D002648:Child; D003131:Combined Modality Therapy; D006801:Humans; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Appendectomy; Appendicitis; Children; Non-operative management; Pediatric