Nonoperative Management Feasible for Pediatric Appendicitis

Less morbidity and lower costs for those choosing nonoperative management versus surgery

a boy on a hospital bed

THURSDAY, Dec. 17, 2015 (HealthDay News) -- For children with uncomplicated acute appendicitis, choosing nonoperative management is an effective treatment strategy, according to a study published online Dec. 16 in JAMA Surgery.

Peter C. Minneci, M.D., from the Research Institute at Nationwide Children's Hospital in Columbus, Ohio, and colleagues examined the effectiveness of patient choice in nonoperative versus surgical management of uncomplicated acute appendicitis in children. One hundred two patients aged 7 to 17 years with acute uncomplicated appendicitis presenting at a single pediatric tertiary acute care hospital were enrolled. Patients and their families gave informed consent and chose between nonoperative management (37 patients) and urgent appendectomy (65 patients).

The researchers found that at 30 days and one year, the success rate of nonoperative management was 89.2 and 75.7 percent, respectively. In the nonoperative group, the incidence of complicated appendicitis was 2.7 percent, compared with 12.3 percent in the surgery group. Compared with the surgery group, children managed nonoperatively had fewer disability days (median, eight versus 21 days; P < 0.001) and lower appendicitis-related health care costs (median, $4,219 versus $5,029; P = 0.01) after one year.

"When chosen by the family, nonoperative management is an effective treatment strategy for children with uncomplicated acute appendicitis, incurring less morbidity and lower costs than surgery," the authors write.

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