SynthesisSurgical endoscopy2020
Management of appendiceal mass and abscess in children; early appendectomy or initial non-operative treatment? A systematic review and meta-analysis.
Synthesis in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Early versus delayed laparoscopic appendectomy for acute uncomplicated appendicitis in adults: a systematic review and meta-analysis.BMC surgery · 2025Pooled it
- Swedish national guidelines for diagnosis and management of acute appendicitis in adults and children.BJS open · 2025Guideline
- Early versus delayed (interval) appendicectomy for the management of appendicular abscess and phlegmon: a systematic review and meta-analysis.Langenbeck's archives of surgery · 2021Pooled it
- Laparoscopic appendectomy for complicated appendicitis with periappendiceal abscess versus without abscess in children: a prospective cohort study.Surgical endoscopy · 2026Review
- Treatment pathways and outcomes for pediatric complex appendicitis patients presenting beyond 3 days: A retrospective cohort study.Langenbeck's archives of surgery · 2026Article
- Post-Appendectomy Intra-Abdominal Abscess in Children with Perforated Appendicitis: A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Comparative evaluation of early versus delayed appendectomy in complicated appendicitis.Bioinformation · 2026Article
- Risk factors for surgical difficulty in interval appendectomy for perforated appendicitis with abscess in children.Pediatric surgery international · 2025Article
- Comparative evaluation of ultrasound-guided versus operative drainage for pediatric appendicular abscess: Effectiveness, safety and clinical outcomes.Bioinformation · 2025Article
- Effects of rhubarb peony decoction combined with antibiotics in treating pediatric periappendiceal abscess.Frontiers in pediatrics · 2023Article
- Article
- Does the presence of an appendicolith or abscess predict failure of nonoperative management of patients with acute appendicitis?Emergency radiology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAppendiceal mass and abscess and its treatment are associated with significant morbidity and high costs. Still, the optimal treatment strategy is the point of debate. Therefore, this systematic review and meta-analysis aimed to compare overall complications between initial non-operative treatment (NOT) and early appendectomy (EA) in children with appendiceal mass and/or abscess.
methodsPubmed and Embase were searched. Only randomized controlled trials and prospective or historical cohort studies that compared NOT with EA in children with appendiceal mass or abscess in terms of complications were eligible for inclusion. Risk of bias was assessed. Primary outcome was the overall complication rate. Secondary, length of stay and readmission rate were investigated. A meta-analysis of overall complications associated with both treatment strategies was performed.
results14 of 7083 screened studies were selected, including 1022 children in the NOT group and 333 in the EA group. Duration of follow-up ranged between four weeks and 12 years. Risk of bias was moderate in four and serious in 10 studies. NOT was associated with a lower overall complication rate (risk ratio (RR) 0.37 [95% confidence interval (CI) 0.21-0.65]). However, NOT led to increased length of stay (mean difference varied between 0.2 and 8.4 days) and higher readmission rate (RR 1.75 [95%CI 0.79-3.89]), although not significantly. Interval appendectomy after NOT was performed as a routine procedure in all but one study. This study found a recurrence rate of 34% in a group of 38 patients during a follow-up period of 3.4 ± 1.7 years.
conclusionNOT may reduce the overall complication rate compared to EA, but the evidence is very uncertain. As evidence is scarce, and of low level, and heterogeneity between studies is substantial, the results should be interpreted with caution. Large prospective studies are needed to determine the optimal treatment strategy for children with appendiceal mass and/or abscess.
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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.