Routine interval appendectomy in children is not indicated

Predictive Factors for Negative Outcomes in Initial Non-operative Management of Suspected Appendicitis

“…[2][3][4]9 In the present series, however, non-operative management was not always effective, and the conversion rate to surgery was higher (40.3%) than those in reported cases (5-20%). [2][3][4]9 This might be partially because the present group possibly consisted of more advanced pathology compared with those in reported cases due to patients' voluntary selection of their initial treatment regardless of the severity of inflammation. Although there was no statistical difference in postoperative complication between primary operation and conversion cases, length of hospital stay was significantly longer, and accordingly, medical costs might be increased in conversion case (data not collected).…”

Initial laparoscopic appendectomy versus initial nonoperative management and interval appendectomy for perforated appendicitis with abscess: a prospective, randomized trial

“…We have used the laparoscopic approach for all patients with appendicitis for the past 8 years, regardless of whether the patient had acute or perforated appendicitis, because of our markedly reduced incidence of wound infections in patients undergoing laparoscopic appendectomy for perforated appendicitis when compared with the open approach. Some groups have reported treating all patients suspected of perforated appendicitis with antibiotics initially with or without interval appendectomy [11][12][13][14]. In addition to the need to have laparoscopic experience with complex operations, the good results attained in the nonoperative group depend on an experienced group of IRs within one's institution.…”

Review of Operative vs. Non-Operative Management of Appendicitis in Pregnancy

“…Moreover, complications of laparoscopic appendectomy, such as stump appendicitis, can be managed with an antibiotics only strategy [123], and that interval appendectomy is not needed in adults [124] or children [125]. Additional review in 2014 revealed that patients who present with phlegmon, abscess <5 cm, who smoke, have generalized abdominal tenderness or tachycardia were more likely to fail non-operative management than patients without these features [126].…”