کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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4154904 | 1273730 | 2016 | 4 صفحه PDF | دانلود رایگان |
BackgroundThe purpose of this study was to investigate the feasibility of nonoperative management of acute appendicitis in children with an appendicolith identified on preoperative imaging.Study designWe performed a prospective nonrandomized trial of nonoperative management of uncomplicated acute appendicitis with an appendicolith in children aged 7 to 17 years. The primary outcome was the failure rate of nonoperative management, defined as having undergone an appendectomy. Early termination was set to occur if the lower limit of the 95% confidence interval of the failure rate was greater than 20% at 30 days or 30% at 1 year.ResultsRecruitment for this study was halted after enrollment of 14 patients (N = 5 nonoperative; N = 9 surgery). The failure rate of nonoperative management was 60% (3/5) at a median follow-up of 4.7 months (IQR 1.0–7.6) with a 95% CI of 23%–88%. None of the three patients that failed nonoperative management had complicated appendicitis at the time of appendectomy, while six out of nine patients who chose surgery had complicated appendicitis (0/3 vs. 6/9, p = 0.18). The trial was stopped for concerns over patient safety.ConclusionsNonoperative management of acute appendicitis with an appendicolith in children resulted in an unacceptably high failure rate.
Journal: Journal of Pediatric Surgery - Volume 51, Issue 6, June 2016, Pages 908–911