# Early versus interval appendectomy in children with complicated appendicitis: effects on hospital stay and occurrence of severe complications

## TL;DR

This study finds that early appendectomy in children with complicated appendicitis leads to shorter hospital stays and fewer overall complications, but carries a risk of more severe postoperative events.

## Contribution

The study provides new comparative evidence on early versus interval appendectomy outcomes in pediatric complicated appendicitis.

## Key findings

- Early appendectomy resulted in significantly shorter hospital stays compared to interval appendectomy.
- The interval appendectomy group had higher overall complication rates.
- Severe complications occurred only in the early appendectomy group.

## Abstract

Acute appendicitis is a common pediatric emergency, yet optimal management of complicated cases remains debated. This study compares outcomes of early vs. interval appendectomy in children with perforated appendicitis.

A retrospective review of 254 patients (<18 years) treated between January 2012 and December 2023 was conducted. Twenty-two underwent interval appendectomy, and 232 underwent early appendectomy. Demographic and clinical data were analyzed using SPSS v29.0.1.0, with statistical significance defined as p < 0.05.

Early appendectomy was associated with a significantly shorter cumulative hospital stay (mean 9.2 days) than interval appendectomy (mean 22.5 days; p < 0.001). Overall complication rates were higher in the interval group (10/22) compared to the early group (31/232; p < 0.001). However, severe complications, such as ileostomy creation, stump insufficiency, and ileocecal pole resection, occurred exclusively in the early appendectomy group.

Early appendectomy in children with complicated appendicitis results in shorter hospitalization and fewer overall complications but carries a risk of more severe postoperative events. Prospective studies are warranted to refine patient selection and optimize treatment strategies.