Trial reportJournal of the American College of Surgeons2014
Feasibility of a nonoperative management strategy for uncomplicated acute appendicitis in children.
Trial report in Journal of the American College of Surgeons, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Non-operative Management of Early Appendicitis in Children
Non-operative Management of Uncomplicated Appendicitis With an Appendicolth in Children
Multi-institutional Trial of Non-operative Management of Uncomplicated Pediatric Appendicitis
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Comparison of Antibiotic Therapy and Appendectomy for Acute Uncomplicated Appendicitis in Children: A Meta-analysis.JAMA pediatrics · 2017Pooled it
- Pooled it
- [Safe surgery and COVID-19: A narrative review].Journal of healthcare quality researchPooled it
- Conservative treatment for uncomplicated appendicitis in children: the CONTRACT feasibility study, including feasibility RCT.Health technology assessment (Winchester, England) · 2021Trial
- Trial
- Trial
- Effects of a Patient Activation Tool on Decision Making Between Surgery and Nonoperative Management for Pediatric Appendicitis: A Randomized Clinical Trial.JAMA network open · 2019Trial
- Retrospective Development of an AI Model Combining Ultrasound and Clinical Data for Pediatric Appendicitis Differentiation.Emergency medicine international · 2025Article
- Management and Incidence ofJournal of clinical medicine · 2024Article
- Endoscopic retrograde appendicitis therapy.Therapeutic advances in gastroenterology · 2024Review
- Non-operative treatment for simple acute appendicitis (NOTA) in children during the COVID-19 era: new lessons from the pandemic.Scientific reports · 2023Article
- Pelvic Health Assessment in Adult Females Following Pediatric Appendicitis: A Monocentric Retrospective Case-Control Study.Children (Basel, Switzerland) · 2022Article
- Composite Criteria for Non-Operative Management of Acute Non-Complicated Appendicitis Result in Low Failure Rates.World journal of surgery · 2022Article
- AThe Ulster medical journal · 2021Article
- Where Did All the Appendicitis Go? Impact of the COVID-19 Pandemic on Volume, Management, and Outcomes of Acute Appendicitis in a Nationwide, Multicenter Analysis.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2021Article
- Diagnostic performance of standardized ultrasound protocol for detecting perforation in pediatric appendicitis.Pediatric radiology · 2019Article
- Multi-institutional trial of non-operative management and surgery for uncomplicated appendicitis in children: Design and rationale.Contemporary clinical trials · 2019Article
- Article
- Perforation risk in pediatric appendicitis: assessment and management.Pediatric health, medicine and therapeutics · 2018Review
- Health economics and quality of life in a feasibility RCT of paediatric acute appendicitis: a protocol study.BMJ paediatrics open · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundFor decades, urgent operation has been considered the only appropriate management of acute appendicitis in children. The purpose of this study was to investigate the feasibility of nonoperative management of uncomplicated acute appendicitis in children. STUDY
designA prospective nonrandomized clinical trial of children with uncomplicated acute appendicitis comparing nonoperative management with urgent appendectomy was performed. The primary result was 30-day success rate of nonoperative management. Secondary outcomes included comparisons of disability days, missed school days, hospital length of stay, and measures of quality of life and health care satisfaction.
resultsSeventy-seven patients were enrolled during October 2012 to October 2013; 30 chose nonoperative management and 47 chose surgery. There were no significant differences in demographic or clinical characteristics. The immediate and 30-day success rates of nonoperative management were 93% (28 of 30) and 90% (27 of 30). There was no evidence of progression of appendicitis to rupture at the time of surgery in the 3 patients for whom nonoperative management failed. Compared with the surgery group, the nonoperative group had fewer disability days (3 vs 17 days; p < 0.0001), returned to school more quickly (3 vs 5 days; p = 0.008), and exhibited higher quality of life scores in both the child (93 vs 88; p = 0.01) and the parent (96 vs 90; p = 0.03), but incurred a longer length of stay (38 vs 20 hours; p < 0.0001).
conclusionsNonoperative management of uncomplicated acute appendicitis in children is feasible, with a high 30-day success rate and short-term benefits that include quicker recovery and improved quality of life scores. Additional follow-up will allow for determination of longer-term success rate, safety, and cost effectiveness.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.