The major primary outcomes show a high recurrence rate and failed treatment associated with the conservative management of appendicitis .
The other outcomes obtained show that there is an increased incidence of complications associated with operative management .
Economic implication s and cost-effectiveness analysis show that conservative treatment may be preferred .
The length of hospital stay was significantly higher in conservative approach to management ; however , shorter time off activities was observed .
Appendicectomy has been accepted as the gold st and ard for the management of appendicitis over the years , but there has been an increasing evidence and trend toward the conservative approach to the management of appendicitis .
The aim of this review is to search existing literature and to evaluate and compare the conservative and operative approaches to the management of appendicitis .
Non-operative management of early, acute appendicitis in children: is it safe and effective?
PURPOSE The purpose of this study was to determine if early , acute appendicitis in children can be safely and effectively managed with antibiotics alone . METHODS A retrospective review was performed of children ( < 18 yrs ) treated non-operatively ( NOM ) for early , acute appendicitis since May 2012 . These were compared to patients treated with appendectomy between January 2011 and October 2011 ( OM ) . Inclusion criteria included : ( a ) symptoms < 48 h , ( b ) localized peritonitis , and ( c ) ultrasound findings consistent with early , acute appendicitis . RESULTS Twelve patients ( 66 % female , mean age 12.2,SD=4.2 yrs ) were treated non-operatively , while 12 ( 50 % female , mean age 12.5,SD=3.2 yrs ) were treated operatively . Two NOM children ( 16.7 % ) required initial appendectomy . One patient developed recurrent appendicitis requiring appendectomy 7 months post-discharge . Four other NOM patients returned with symptoms but did not require admission or surgery . Two OM patients ( 8.3 % ) had hospital visits and admissions related to surgical site infections . Mean length of stay ( LOS ) for the first visit was 1.5 days ( SD=1.0d ) ( NOM ) vs. 1.3 days ( SD=0.5d ) ( OM ) ( p=0.61 ) . Including first and subsequent admissions , mean LOS was 1.8 days ( SD=1.1d ) ( NOM ) vs. 1.7 days ( SD=1.5d ) ( OM ) ( p=0.97 ) . CONCLUSION Early acute appendicitis in appropriately selected children can be successfully treated non-operatively . R and omized trials with longer follow-up are required
The major primary outcomes show a high recurrence rate and failed treatment associated with the conservative management of appendicitis .
The other outcomes obtained show that there is an increased incidence of complications associated with operative management .
Economic implication s and cost-effectiveness analysis show that conservative treatment may be preferred .
The length of hospital stay was significantly higher in conservative approach to management ; however , shorter time off activities was observed .
Appendicectomy has been accepted as the gold st and ard for the management of appendicitis over the years , but there has been an increasing evidence and trend toward the conservative approach to the management of appendicitis .
The aim of this review is to search existing literature and to evaluate and compare the conservative and operative approaches to the management of appendicitis .