Efficacy and Safety of Nonoperative Treatment for Acute Appendicitis: A Meta-analysis

@article{Georgiou2017EfficacyAS,
  title={Efficacy and Safety of Nonoperative Treatment for Acute Appendicitis: A Meta-analysis},
  author={Roxani Georgiou and Simon Eaton and Michael P Stanton and Agostino Pierro and Nigel J Hall},
  journal={Pediatrics},
  year={2017},
  volume={139}
}
This systematic review of the existing literature with meta-analysis reports on the efficacy and safety of nonoperative treatment of acute uncomplicated appendicitis in children relative to appendectomy. CONTEXT: Nonoperative treatment (NOT) with antibiotics alone of acute uncomplicated appendicitis (AUA) in children has been proposed as an alternative to appendectomy. OBJECTIVE: To determine safety and efficacy of NOT based on current literature. DATA SOURCES: Three electronic databases. STUDY… Expand
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Nonoperative 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. Expand
Nonoperative treatment of acute appendicitis in children: A feasibility study.
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Despite occasional late recurrences, antibiotic-only treatment of early appendicitis in children is feasible, safe, cost-effective and is experienced more favorably by patients and parents. Expand
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In the per-protocol meta-analysis, there was no difference between operative versus nonoperative management in failure of treatment, and the complication rate was significantly lower in patients treated nonoperatively. Expand
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Early acute appendicitis in appropriately selected children can be successfully treated non-operatively with antibiotics alone, and Randomized trials with longer follow-up are required. Expand
Antibiotics Versus Appendicectomy for the Treatment of Uncomplicated Acute Appendicitis: An Updated Meta-Analysis of Randomised Controlled Trials
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Increasing evidence supports the primary treatment of acute uncomplicated appendicitis with antibiotics, in terms of complications, hospital LOS and risk of complicated appendicectomy. Expand
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This pilot trial suggests that nonoperatively treatment of acute appendicitis in children is feasible and safe and that further investigation of nonoperative treatment is warranted. Expand
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TLDR
There is a wide heterogeneity in the selection and definition of outcomes in paediatric appendicitis, and little overlap in outcomes used across studies, which preclude meaningful evidence synthesis and pose challenges to designing prospective clinical trials and cohort studies. Expand
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TLDR
It is found that some of the patients who had a history of abdominal pain for less than 24 hours with localized abdominal tenderness and hemodynamic stability could be treated nonoperatively. Expand
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TLDR
The overall nonoperative treatment failure including both early failure and recurrence occurred more frequently among those with appendicoliths than without appendioliths, and Satisfaction levels were higher for operative treatment. Expand
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TLDR
It is concluded that appendectomy remains the standard treatment for acute appendicitis and antibiotic treatment might be used as an alternative treatment in a good quality RCT or in specific patients or conditions were surgery is contraindicated. Expand
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