Format

Send to

Choose Destination
Arch Surg. 2011 Jun;146(6):660-5. doi: 10.1001/archsurg.2011.6. Epub 2011 Feb 21.

Early vs interval appendectomy for children with perforated appendicitis.

Author information

1
Division of Pediatric Surgery, University of Tennessee Health Science Center, Memphis, TN 38111, USA. mblakely@uthsc.edu

Abstract

OBJECTIVE:

To compare the effectiveness and adverse event rates of early vs interval appendectomy in children with perforated appendicitis.

DESIGN:

Nonblinded randomized trial.

SETTING:

A tertiary-referral urban children's hospital.

PATIENTS:

A total of 131 patients younger than 18 years with a preoperative diagnosis of perforated appendicitis.

INTERVENTIONS:

Early appendectomy (within 24 hours of admission) vs interval appendectomy (6-8 weeks after diagnosis).

MAIN OUTCOME MEASURES:

Time away from normal activities (days). Secondary outcomes included the overall adverse event rates and the rate of predefined specific adverse events (eg, intra-abdominal abscess, surgical site infection, unplanned readmission).

RESULTS:

Early appendectomy, compared with interval appendectomy, significantly reduced the time away from normal activities (mean, 13.8 vs 19.4 days; P < .001). The overall adverse event rate was 30% for early appendectomy vs 55% for interval appendectomy (relative risk with interval appendectomy, 1.86; 95% confidence interval, 1.21-2.87; P = .003). Of the patients randomized to interval appendectomy, 23 (34%) had an appendectomy earlier than planned owing to failure to improve (n = 17), recurrent appendicitis (n = 5), or other reasons (n = 1).

CONCLUSIONS:

Early appendectomy significantly reduced the time away from normal activities. The overall adverse event rate after early appendectomy was significantly lower compared with interval appendectomy.

TRIAL REGISTRATION:

clinicaltrials.gov Identifier: NCT00435032.

PMID:
21339413
DOI:
10.1001/archsurg.2011.6
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center