Our Summary

This research paper is about the cost-effectiveness of two treatment methods for children’s uncomplicated acute appendicitis. One is a non-surgical method (NOM) that uses only antibiotics, and the other is a surgical method, specifically laparoscopic appendectomy (removal of the appendix through small incisions).

The study used real-world data from a controlled trial and calculated costs based on initial hospitalization, readmissions, and emergency department visits. They also took into account the impact on the patient’s quality of life and disability days.

Out of 1,068 patients, 370 chose the non-surgical method and 698 chose surgery. On average, the surgical method cost $9,791 per patient and resulted in a quality of life score of 0.884. The non-surgical method cost $8,044 per patient and resulted in a better quality of life score of 0.895.

The researchers concluded that the non-surgical method is both cheaper and more effective for treating uncomplicated appendicitis in children for one year.

FAQs

  1. What are the two treatment methods for children’s uncomplicated acute appendicitis studied in the research?
  2. How was the cost-effectiveness of the treatment methods calculated in this study?
  3. What were the cost and quality of life outcomes for the non-surgical method compared to the surgical method in treating uncomplicated appendicitis in children?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric appendectomy is that in cases of uncomplicated acute appendicitis, non-surgical treatment with antibiotics may be a cost-effective and equally effective option compared to surgery. It is important to discuss both treatment options with your healthcare provider to determine the best course of action for your child.

Suitable For

Pediatric patients who are recommended for pediatric appendectomy are typically those who have been diagnosed with uncomplicated acute appendicitis. Uncomplicated appendicitis refers to cases where the appendix is inflamed but has not ruptured or formed an abscess. These patients may present with symptoms such as abdominal pain, fever, vomiting, and possibly rebound tenderness.

In the study mentioned above, the patients included in the analysis were children with uncomplicated acute appendicitis who were eligible for either the non-surgical or surgical treatment methods. It is important to note that the decision to recommend pediatric appendectomy may vary depending on the severity of the condition, the age of the patient, any underlying medical conditions, and the preferences of the patient and their family.

Overall, pediatric patients recommended for pediatric appendectomy are those who would benefit from the removal of the inflamed appendix to prevent potential complications such as perforation, abscess formation, and peritonitis. The choice between non-surgical and surgical treatment methods may depend on factors such as the patient’s overall health, the severity of symptoms, and the potential risks and benefits of each approach.

Timeline

Timeline of a pediatric appendectomy experience:

Before appendectomy:

  1. Patient presents with symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever.
  2. Patient undergoes physical examination, blood tests, and imaging studies to diagnose appendicitis.
  3. Surgical consultation is scheduled to discuss treatment options.
  4. Patient and family decide on treatment method, either non-surgical (NOM) or surgical (laparoscopic appendectomy).
  5. Patient may need to fast before surgery and follow pre-surgical instructions.

After appendectomy:

  1. Patient undergoes surgery and stays in the hospital for a period of time to recover.
  2. Patient receives post-operative care, including pain management and monitoring for complications.
  3. Patient may experience pain, fatigue, and limited mobility in the days following surgery.
  4. Patient is discharged from the hospital and instructed on post-operative care, such as wound care and activity restrictions.
  5. Patient may need follow-up appointments with the surgeon to ensure proper healing.
  6. Patient gradually returns to normal activities and diet as recovery progresses.
  7. Patient may experience improved quality of life and resolution of symptoms after surgery.

Overall, the timeline of a pediatric appendectomy involves a period of pre-operative evaluation and decision-making, followed by surgery and post-operative recovery. The choice of treatment method, such as NOM or laparoscopic appendectomy, can impact the patient’s experience and outcomes.

What to Ask Your Doctor

  1. What are the potential risks and benefits of each treatment method (NOM vs. laparoscopic appendectomy) for pediatric appendicitis?
  2. How do the costs of the two treatment methods compare, including initial hospitalization, readmissions, and emergency department visits?
  3. What is the impact on the child’s quality of life for each treatment method?
  4. Are there any long-term implications or considerations for choosing one treatment method over the other?
  5. How does the choice of treatment method affect the likelihood of recurrence or complications in the future?
  6. Are there any specific factors or criteria that should be taken into consideration when deciding between NOM and laparoscopic appendectomy for a child with uncomplicated acute appendicitis?
  7. Are there any additional resources or information available to help guide the decision-making process for pediatric appendectomy treatment options?

Reference

Authors: Gil LA, Asti L, Chen HF, Saito JM, Pattisapu P, Deans KJ, Minneci PC; Midwest Pediatric Surgery Consortium. Journal: J Am Coll Surg. 2025 Mar 1;240(3):288-298. doi: 10.1097/XCS.0000000000001232. Epub 2025 Feb 14. PMID: 39560281