Can Physicians Delay Appendectomy for One Night in Children With Acute Appendicitis?

TL;DR

This study finds that delaying appendectomy for up to 18 hours in children with acute appendicitis does not increase complication risks.

Contribution

The study provides evidence that immediate appendectomy is not always necessary for children with acute appendicitis.

Findings

No significant difference in surgical site infection rates between immediate and delayed appendectomy groups.

No increased risk of perforation with delayed appendectomy up to 18 hours.

Demographic and clinical outcomes were comparable between the two groups.

Abstract

In pediatrics, appendicitis is the leading cause of emergency surgery. It was previously believed that postponing the surgery could lead to the appendix rupture. Children with this condition can be difficult to diagnose. The evidence regarding the necessity of an immediate appendectomy is a topic of debate. In this study, we evaluated the medical records of patients who were diagnosed with acute appendicitis to determine whether postponing appendectomy for one night is safe or not.

This study involved 534 individuals diagnosed with acute appendicitis, who were separated into two groups: those who underwent an appendectomy immediately (within 8 hours) and those who had a delayed procedure (between 8-18 hours). We recorded and compared demographic data, symptoms, laboratory results, time of symptoms, hospitalization duration, surgery duration, overall time, length of stay after surgery, and any other complications that occurred between the two groups.

The rate of surgical site infection (SSI) did not differ significantly between the groups (2.8% vs 4.2%, P=0.74). Additionally, there was no significant difference in the risk of perforation between the time of surgery in our study (21.9% vs 19.8%, P>0.05).

Our findings suggest that there is no increased risk of complications such as perforation when appendectomy is delayed for up to 18 hours.