WOFAPS 2025 8th World Congress of Pediatric Surgery

Franziska Cramer, Yannick Schmidt, Oliver Muensterer, Danielle Wendling-Keim

Department of Pediatric Surgery, Dr. von Hauner Children´s Hospital, University Hospital, LMU, Munich, Germany

Purpose:

Acute appendicitis is one of the most common surgical emergencies affecting children. The optimal management of perforated appendicitis in children remains controversial. Early appendectomy and interval appendectomy are both available options. The aim of this study is to analyze which treatment option is most beneficial for children with perforated appendicitis.

Method:

A total of 254 patients were retrospectively reviewed from January 1, 2012, to December 31, 2023. Of these patients, 22 patients underwent interval appendectomy, and the remaining 232 patients underwent early appendectomy. Patient data were tabulated in Excel version 2407 and statistically analysed using IBM SPSS Statistics version 29.0.1.0 (171). The level of significance was defined as a p-value of <0.05. The inclusion criteria were age below 18 years and the presence of perforated appendicitis. This study was approved by the ethics committee and was conducted as a retrospective observational study.

Results:

Patients who underwent early appendectomy had a significantly shorter cumulative length of hospital stay (p <0.001) compared to those who underwent interval appendectomy. Patients who underwent an interval appendectomy had a mean cumulative hospital stay of 22.5 days, while those who underwent an early appendectomy had a mean hospital stay of 9.2 days. Although the interval appendectomy group showed a significantly (p<0.001) higher number of complications requiring treatment (10/22), compared to the early appendectomy group (31/232) the occurrence of severe complications including ileostomy creation, stump insufficiency and ileocecal pole resection were seen only in the early appendectomy group but not in the interval appendectomy group.

Conclusion:

In our study, early appendectomy was associated with shorter hospital stay, fewer overall complications, but more severe complications compared to interval appendectomy. Further prospective studies are needed to confirm these findings.