Our Summary

The researchers aimed to determine whether surgery or non-surgical treatment was more effective and safe for children with simple appendicitis. They looked at data and relevant studies up until September 2018. They found nine studies that fit their criteria and used a software called STATA for analysis.

Their findings showed that there was a significant difference in how successful the treatment was after one month and one year. However, there wasn’t a significant difference in the amount of complications that occurred. They also found that children with fecaliths (hardened stool that’s stuck in the appendix) had less effective results from non-surgical treatment.

In conclusion, non-surgical treatment (also known as conservative treatment) for children with appendicitis was found to be safe and doable. However, surgery was a better option for children with fecaliths.

FAQs

  1. How does conservative treatment compare to surgery for pediatric appendicitis?
  2. What was the success rate of treatment after 1 month and 1 year in the study?
  3. Are there any specific cases in which appendectomy is a better choice than conservative treatment for pediatric appendicitis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric appendectomy is to discuss the option of conservative treatment with the healthcare provider. In some cases, antibiotics and observation may be a safe and effective alternative to surgery for uncomplicated cases of pediatric appendicitis. However, it is important to note that appendectomy may be the better choice for patients with fecaliths. It is essential to have a thorough discussion with the healthcare provider to determine the best course of treatment for each individual case.

Suitable For

Pediatric patients with uncomplicated appendicitis are typically recommended for pediatric appendectomy. In particular, patients with fecaliths may benefit more from surgery rather than conservative treatment.

Timeline

  • Before pediatric appendectomy:
  1. Patient experiences abdominal pain, usually starting around the belly button and moving to the lower right abdomen.
  2. Other symptoms may include nausea, vomiting, loss of appetite, and fever.
  3. Patient undergoes physical examination, blood tests, and imaging tests such as ultrasound or CT scan to diagnose appendicitis.
  4. Treatment options are discussed with the patient and their parents, including conservative management with antibiotics or surgical removal of the appendix (appendectomy).
  5. If appendectomy is chosen, the patient may need to fast before the surgery and will be given anesthesia during the procedure.
  • After pediatric appendectomy:
  1. Patient undergoes the surgical procedure to remove the inflamed appendix.
  2. Recovery time varies, but most patients are able to go home within a day or two after surgery.
  3. Patient may experience some pain and discomfort after surgery, which can be managed with pain medication.
  4. Patient will need to follow post-operative instructions, such as avoiding strenuous activities and lifting heavy objects.
  5. Follow-up appointments will be scheduled to monitor the patient’s recovery and ensure there are no complications.
  6. In the long term, patients who undergo appendectomy have a lower risk of recurrent appendicitis compared to those who receive conservative treatment with antibiotics.

What to Ask Your Doctor

  1. What are the potential risks and benefits of undergoing an appendectomy for my child’s uncomplicated pediatric appendicitis?
  2. How successful is conservative treatment compared to surgery in treating uncomplicated pediatric appendicitis?
  3. Are there any specific factors, such as the presence of fecaliths, that may make surgery a more appropriate choice for my child?
  4. What is the typical recovery time for a child undergoing an appendectomy?
  5. Are there any long-term implications or complications associated with either conservative treatment or surgery for pediatric appendicitis?
  6. How will my child’s quality of life be impacted by choosing conservative treatment versus surgery?
  7. Are there any alternative treatment options that may be suitable for my child’s condition?
  8. What are the criteria for determining whether surgery is necessary for my child’s uncomplicated pediatric appendicitis?
  9. How often do complications occur with appendectomies in pediatric patients, and how are they typically managed?
  10. Are there any specific post-operative care instructions or follow-up appointments that I should be aware of for my child after undergoing an appendectomy?

Reference

Authors: Bi LW, Yan BL, Yang QY, Cui HL. Journal: J Comp Eff Res. 2019 Jul;8(10):767-780. doi: 10.2217/cer-2019-0036. Epub 2019 May 29. PMID: 31137951