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Studies have shown that non-operative management of uncomplicated appendicitis with antibiotics is effective in children and adults. But these studies did not consider the preferences of patients or their families, which may affect outcomes.
A study conducted at the Nationwide Children’s Hospital in Ohio gave parents the choice of appendectomy (n=65) or non-operative management (n=37) for children with uncomplicated appendicitis.
The non-operative strategy involved a minimum 24 hours of inpatient observation with IV antibiotics and a ten-day course of oral antibiotics. After one year, three-quarters of these patients were able to avoid surgery. Additionally, these children had fewer disability days (median 8 vs 21) and lower appendicitis-related healthcare costs (median US$4,219 [£3,000] vs US$5,029 [£4,000]).
When chosen by the family, non-operative management is effective for uncomplicated appendicitis, conclude the researchers in JAMA Surgery (online, 16 December 2015)[1]
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References
[1] Minneci PC, Mahida JB, Lodwick DL et al. Effectiveness of patient choice in nonoperative vs surgical management of pediatric uncomplicated acute appendicitis. JAMA Surgery 2015. doi:10.1001/jamasurg.2015.4534.
