AI Article Synopsis
- The study investigates whether conservative antibiotic treatment (CAT) is a viable alternative to appendectomy for children with uncomplicated acute appendicitis.
- Data was collected from 362 children treated with CAT, showing that most (86.8%) did not require surgery, but some still needed appendectomies later due to recurrences.
- The findings indicate that CAT can be a safe and effective treatment strategy, provided strict diagnostic criteria are followed, though it doesn’t replace surgery for all cases.
Article Abstract
Purpose: Appendectomy versus conservative antibiotic treatment (CAT) for children with acute uncomplicated appendicitis (AUA) remains unresolved, with concerns regarding the practicality of CAT. We analyzed our center's experience with CAT for AUA, using a protocol with strict inclusion, exclusion and treatment criteria.
Methods: Non-randomized, prospective cohort study included all children admitted betwee 2014 and 2016, with clinical and laboratory tests suspicious for AUA. Data collected included clinical signs and symptoms; laboratory, ultrasound and pathology results. Follow-up was conducted through clinic visits, telephone conversations and national registry analysis.
Results: Included in CAT: 362 children, 19 underwent appendectomy within 1-2 days. Overall, 75 were readmitted for recurrent acute appendicitis during 22 months (6-43) follow-up. Thirty were treated successfully with antibiotics a second time. The remaining 45 had appendectomy. Overall, 86.8% underwent CAT with no surgery. Histology of all recurrent AUA revealed no perforations.
Conclusion: We confirm the feasibility of conservative management of AUA in children. A rigorous diagnostic plan with strict inclusion and exclusion criteria will lead to high success rate of CAT with a strong safety profile. CAT does not compete with surgery or render appendectomy unnecessary. It is a safe alternative to surgery in selected cases.
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| http://dx.doi.org/10.1007/s00383-018-4226-4 | DOI Listing |
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