Influence of Appendectomy Timing in the Pathological Outcome and the Morbidity of Acute Appendicitis in Children: A Retrospective Study

Abstract

Introduction: Surgery is indicated for acute appendicitis but there is controversy regarding precise timing for appendectomy.Objective: Our aim was to evaluate the impact of time delay from emergency department presentation to surgery in developing complicated appendicitis in children and associated morbidity.Methods: 540 charts of children, who underwent appendectomy, between January 2013 and December 2016 were retrospectively reviewed. Groups were divided by time of intervention. Group 1: less than 24h (n=209, 38.7%), group 2: 24h to 48h (n=293, 54.5%), and group 3: greater than 48h (n=38, 6.8%). We considered complicated appendicitis gangrenous, abscess or perforated appendix per operatively and on histopathologic examination. Statically analysis and was performed to search the predictors of complicated appendicitis and evaluate postoperative complications.Results: Among 540 children included in the study, 164 (30.4%) had complicated acute appendicitis. There was no correlation between delay to surgery and the risk of developing a complicated form of the disease for group 1 and Group 2. Beyond the 48 th h (group 3), the rate of developing complicated appendicitis and post-operative complications increased significantly. Hospital stay was not affected by delayed surgery. Conclusion:A short in-hospital delay before surgery less than 48 h, for acute appendicitis in child, is not associated with an increased rate of complex appendicitis neither associated morbidity.