Our Summary

This research study, known as the APPSYPP trial, aims to compare how effectively two different treatments for uncomplicated acute appendicitis in children work. The two treatments are: an immediate surgery to remove the appendix (appendectomy), and treating the symptoms of the appendicitis first, which includes providing fluids and pain relief. The study involves children aged between 7 and 16 who have confirmed appendicitis but are not showing severe symptoms. The success of the treatment is measured by how well the patient is doing 30 days after the treatment. If a patient has had surgery, it’s considered a failure if the appendix was normal or if there were complications from the surgery. If the patient was treated symptomatically, it’s deemed a failure if they end up needing surgery, if their appendicitis worsens during their hospital stay, if they develop appendicitis after leaving the hospital, or if they experience any complications from the appendicitis that require surgery. The results of this trial will be shared in scientific journals. It has been approved by an ethics committee and is registered on a clinical trials website.

FAQs

  1. What is the purpose of the APPSYPP trial?
  2. How is the success of the treatment for uncomplicated acute appendicitis in children measured in this study?
  3. What are considered as failures of the two different treatments for acute appendicitis in children?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric appendectomy is to follow post-operative care instructions carefully. This may include taking prescribed medications, getting plenty of rest, and avoiding strenuous activity. It’s important to attend follow-up appointments with your healthcare provider to ensure proper healing and to address any concerns or complications that may arise. It’s also important to monitor for signs of infection, such as increased pain, redness, or swelling around the incision site, and to seek medical attention if these symptoms occur.

Suitable For

Patients who are typically recommended for pediatric appendectomy are children aged between 7 and 16 with confirmed uncomplicated acute appendicitis. These patients are not showing severe symptoms and are eligible for either immediate surgery or symptomatic treatment as part of the APPSYPP trial. It is important to note that patients with complicated appendicitis or severe symptoms may not be suitable for this study and may require immediate surgical intervention.

Timeline

  • Day 1: The patient experiences symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever. They visit the doctor and are diagnosed with uncomplicated acute appendicitis.
  • Day 2-3: The patient is admitted to the hospital and undergoes tests to confirm the diagnosis. They are then enrolled in the APPSYPP trial and randomized to receive either immediate appendectomy or symptomatic treatment.
  • Day 4-5: If the patient is in the surgery group, they undergo the appendectomy procedure. If they are in the symptomatic treatment group, they receive fluids, pain relief, and monitoring of their symptoms.
  • Day 6-30: The patient is monitored for any complications or worsening of their condition. They may be discharged from the hospital if their symptoms improve.
  • Day 30 and beyond: The patient is followed up to assess the success of the treatment. If they had surgery, they are considered a success if the appendix was inflamed and there were no complications. If they were treated symptomatically, they are considered a success if they did not require surgery and did not experience any complications.

What to Ask Your Doctor

  1. What are the potential risks and benefits of having an immediate appendectomy for my child?
  2. How does the success rate of treating the symptoms of appendicitis first compare to the success rate of undergoing surgery?
  3. Are there any long-term consequences or complications associated with either treatment option?
  4. How will my child’s recovery process differ between the two treatment options?
  5. Will my child need any additional follow-up care or monitoring after the treatment?
  6. Are there any specific criteria that make my child a better candidate for one treatment option over the other?
  7. How will the decision between immediate surgery and symptomatic treatment be made for my child?
  8. What is the expected timeline for my child to return to normal activities after either treatment option?
  9. Are there any lifestyle changes my child should make following the treatment for appendicitis?
  10. Are there any alternative treatment options available for my child’s appendicitis?

Reference

Authors: Puputti J, Suominen JS, Luoto T, Hiltunen P, Ripatti L, Nikoskelainen M, Nuutinen S, Sinikumpu JJ, Tahkola E, Porela-Tiihonen S, Hurme S, Salminen P, Pakarinen MP. Journal: Contemp Clin Trials. 2022 Dec;123:106970. doi: 10.1016/j.cct.2022.106970. Epub 2022 Oct 22. PMID: 36280033