Key result
Delaying pediatric appendectomy 8-18 hours does not increase surgical site infection or perforation risk.
Why the study?
It was previously believed that postponing surgery could lead to appendix rupture, but the necessity of an immediate appendectomy in children remains debated.
Does delaying appendectomy for 8-18 hours increase the risk of complications compared to immediate appendectomy in children with acute appendicitis?
Cohort (n=534)
Does delaying appendectomy for 8-18 hours increase the risk of complications compared to immediate appendectomy in children with acute appendicitis?
Delaying appendectomy for up to 18 hours in children with acute appendicitis appears safe and does not increase the risk of surgical site infection or perforation.
May support delayed appendectomy up to 18 hours in children; observational data challenges historical urgency yet leaves open need for RCTs.
Background: In pediatrics, appendicitis is the leading cause of emergency surgery. It was previously believed that postponing the surgery could lead to the appendix rupture. Children with this condition can be difficult to diagnose. The evidence regarding the necessity of an immediate appendectomy is a topic of debate. In this study, we evaluated the medical records of patients who were diagnosed with acute appendicitis to determine whether postponing appendectomy for one night is safe or not. Methods: This study involved 534 individuals diagnosed with acute appendicitis, who were separated into two groups: those who underwent an appendectomy immediately (within 8 hours) and those who had a delayed procedure (between 8-18 hours). We recorded and compared demographic data, symptoms, laboratory results, time of symptoms, hospitalization duration, surgery duration, overall time, length of stay after surgery, and any other complications that occurred between the two groups. Results: The rate of surgical site infection (SSI) did not differ significantly between the groups (2.8% vs 4.2%, P=0.74). Additionally, there was no significant difference in the risk of perforation between the time of surgery in our study (21.9% vs 19.8%, P>0.05). Conclusion: Our findings suggest that there is no increased risk of complications such as perforation when appendectomy is delayed for up to 18 hours.
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Salimi et al. (2024) conducted a cohort in Acute appendicitis (n=534). Delayed appendectomy (8-18 hours) vs. Immediate appendectomy (within 8 hours) was evaluated on Surgical site infection (SSI) (p=0.74). Delaying appendectomy for 8-18 hours in children with acute appendicitis did not significantly increase the risk of surgical site infection (4.2% vs 2.8%, P=0.74) or perforation.
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