With significantly higher efficacy and low complication rates , appendectomy remains the most effective treatment for patients with uncomplicated AA .
BACKGROUND Acute appendicitis is the most common surgical diagnosis in young patients , with lifetime prevalence of about 7 % .
Debate remains on whether uncomplicated AA should be operated or not .
Aim of this meta- analysis of r and omized controlled trials was to assess current evidence on antibiotic treatment for uncomplicated AA compared to st and ard surgical treatment .
Nonoperative treatment with antibiotics versus surgery for acute nonperforated appendicitis in children: a pilot randomized controlled trial.
OBJECTIVE The aim of this study was to evaluate the feasibility and safety of nonoperative treatment of acute nonperforated appendicitis with antibiotics in children . METHODS A pilot r and omized controlled trial was performed comparing nonoperative treatment with antibiotics versus surgery for acute appendicitis in children . Patients with imaging-confirmed acute nonperforated appendicitis who would normally have had emergency appendectomy were r and omized either to treatment with antibiotics or to surgery . Follow-up was for 1 year . RESULTS Fifty patients were enrolled ; 26 were r and omized to surgery and 24 to nonoperative treatment with  antibiotics . All children in the surgery group had histopathologically confirmed acute appendicitis , and there were no significant complications in this group . Two of 24 patients in the nonoperative treatment group had appendectomy within the time of primary antibiotic treatment and 1 patient after 9 months for recurrent acute appendicitis . Another 6 patients have had an appendectomy due to recurrent abdominal pain ( n = 5 ) or parental wish ( n = 1 ) during the follow-up period ; none of these 6 patients had evidence of appendicitis on histopathological examination . CONCLUSIONS Twenty-two of 24 patients ( 92 % ) treated with antibiotics had initial resolution of symptoms . Of these 22 , only 1 patient ( 5 % ) had recurrence of acute appendicitis during follow-up . Overall , 62 % of patients have not had an appendectomy during the follow-up period . This pilot trial suggests that nonoperative treatment of acute appendicitis in children is feasible and safe and that further investigation of nonoperative treatment is warranted
With significantly higher efficacy and low complication rates , appendectomy remains the most effective treatment for patients with uncomplicated AA .
BACKGROUND Acute appendicitis is the most common surgical diagnosis in young patients , with lifetime prevalence of about 7 % .
Debate remains on whether uncomplicated AA should be operated or not .
Aim of this meta- analysis of r and omized controlled trials was to assess current evidence on antibiotic treatment for uncomplicated AA compared to st and ard surgical treatment .