Journal article
Reevaluating Nonoperative Management for Pediatric Uncomplicated Acute Appendicitis: A Systematic Review and Meta-Analysis
Annals of emergency medicine, Vol.87(6), pp.749-750
06/2026
DOI: 10.1016/j.annemergmed.2025.11.015
PMID: 41563152
Abstract
Take-Home Message
Nonoperative management of uncomplicated acute appendicitis in the pediatric population is associated with higher treatment failure and major complication rates than surgical intervention; however, there are early advantages to nonoperative management, including faster return to school and activities.
Methods
The authors searched 5 electronic databases. Studies included randomized controlled trials comparing nonoperative management versus surgery of uncomplicated appendicitis in children and adolescents. Outcomes were treatment success, which was defined as absence of unplanned operations and complications, lack of recurrent appendicitis (for the nonoperative management group), and absence of negative appendectomy (in the surgical group); treatment failure, which was defined as need for intervention within 48 hours, appendicitis recurrence, or need for appendectomy (nonoperative management group), and complications and additional procedures requiring general anesthesia; complications; time to return to activities and school; length of stay; recurrence; readmissions; negative appendectomy; mortality; and hospital expenses. Quality was assessed using the Cochrane Risk of Bias 2 tool. The primary analyses were reported as a relative risk for categorical endpoints and mean differences for continuous outcomes, with 95% confidence intervals (CIs). A leave-1-out sensitivity analysis was performed for all outcomes. To assess the robustness of findings, a trial sequential analysis was performed.
Details
- Title: Subtitle
- Reevaluating Nonoperative Management for Pediatric Uncomplicated Acute Appendicitis: A Systematic Review and Meta-Analysis
- Creators
- Giovana Landal de Almeida Lobo - Department of Emergency Medicine, University of Iowa Healthcare, Iowa City, IASangil Lee - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Annals of emergency medicine, Vol.87(6), pp.749-750
- DOI
- 10.1016/j.annemergmed.2025.11.015
- PMID
- 41563152
- NLM abbreviation
- Ann Emerg Med
- ISSN
- 1097-6760
- eISSN
- 1097-6760
- Publisher
- Elsevier
- Language
- English
- Electronic publication date
- 01/20/2026
- Date published
- 06/2026
- Academic Unit
- Emergency Medicine; Injury Prevention Research Center
- Record Identifier
- 9985130059702771
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