Evidence map›Paper›PMID 41194121›Full record

SynthesisWorld journal of emergency surgery : WJES2025

Clinical efficacy and safety of endoscopic retrograde appendicitis treatment for acute appendicitis in children: a systematic review and meta-analysis.

Shen Li, Tian Geng, Zhongyue Li

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in World journal of emergency surgery : WJES, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Shen LiDepartment of Pediatrics, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, China.
Tian GengDepartment of Pediatrics, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, China.
Zhongyue LiDepartment of Pediatrics, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, China. 6195006@zju.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the clinical efficacy of endoscopic retrograde appendicitis therapy (ERAT) in the management of acute appendicitis in pediatric patients.

methodsA comprehensive search was conducted across seven electronic databases. Methodological quality of included studies was assessed using the Cochrane risk of bias tool. Statistical analyses were performed using RevMan 5.3 and Stata 13 software.

resultsTen studies involving 1,372 pediatric patients were included (ERAT group: 660; control group: 712). Compared to the control group, the ERAT group demonstrated significant advantages in multiple outcomes: shorter operative time [WMD = - 9.98, 95%CI: (-17.47, - 2.49); P = 0.009], higher fecalith detection rate [RR = 1.81, 95%CI: (1.43, 2.30); P < 0.00001], shorter postoperative feeding time [SMD = - 3.21, 95%CI: (- 4.04, - 2.38); P < 0.00001], lower postoperative white blood cell count [WMD = - 1.45, 95%CI: (- 1.93, - 0.96); P < 0.00001], faster normalization of white blood cell levels [WMD = - 1.62, 95%CI: (- 2.03, - 1.20); P < 0.00001], quicker resolution of fever [WMD = - 1.15, 95%CI: (- 1.48, - 0.81); P < 0.00001], shorter duration of abdominal pain relief [SMD = - 1.18, 95%CI: (- 1.59, - 0.77); P < 0.00001], reduced bed rest time [WMD = - 1.39, 95%CI: (- 1.61, - 1.18); P < 0.00001], fewer complications [RR = 0.27, 95%CI: (0.18, 0.39); P < 0.00001], higher initial treatment success rate [RR = 1.11, 95%CI: (1.06, 1.16); P < 0.0001], shorter hospital stay [WMD = - 2.21, 95%CI: (- 2.69, - 1.73); P < 0.00001], and lower hospitalization costs [SMD = - 2.84, 95%CI: (- 3.47, - 2.20); P < 0.00001]. However, no statistically significant difference was observed in recurrence rates between groups [RR = 0.78, 95%CI: (0.51, 1.19); P = 0.24].

conclusionsERAT demonstrates unique advantages in pediatric acute appendicitis, including alleviating symptoms, accelerating recovery, reducing hospitalization duration and costs, minimizing complications, preserving appendiceal function, and optimizing healthcare resource utilization. Nevertheless, postoperative recurrence remains a concern, necessitating further validation through multicenter, large-scale randomized controlled trials. STUDY REGISTRATION: PROSPERO CRD420251020742, date of registration: March 27th, 2025.

Indexed as

AppendectomyAppendicitisEndoscopyChildHumansTreatment OutcomeAcute appendicitisChildrenEndoscopic retrograde appendicitis therapyMeta-analysisSystematic review

Identifiers

PMID41194121
PMCPMC12587718

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.