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Acute appendicitis in children: can surgery be postponed? Short-term results in a cohort of 225 children

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Abstract

Purpose

To our knowledge, there is no German study, which has examined the relationship between a postponement of surgery (from emergency service to standard working time) and the corresponding risk of postoperative complications in children and adolescents with acute appendicitis. The aim of this study is to examine if surgery of acute appendicitis in childhood can be postponed from night shift to the next working day without negative effects for the patient.

Methods

In a retrospective analysis (September 2001 to June 2007), the files of 225 paediatric surgical patients with acute appendicitis have been analysed concerning history, histology, course of treatment and development of complications. The cohort was divided into groups by their histology (common, “A”, complicated appendicitis, “B”) and by the median time (10 h) from admission to surgery (immediate, “C”, delayed surgery, “D”). These groups have been analysed and compared.

Results

Groups A and B did not differ concerning time to admittance (p = 0.922). Seven patients developed complications (n = 7/225, 3.1%). Six complications were seen in group C (n = 6/113, 5.3%) compared to 1 in group D (n = 1/112, 0.9%), the difference was not significant (p = 0.119). None of the patients of group B developed complications after delayed surgery. Median follow-up was 10 days (IQR 7–15).

Conclusions

In view of the development of complications, there was no evidence that the time between inpatient admission and surgery had any impact on the postoperative result. Thus, there is usually no need to perform surgery in common appendicitis during night shift.

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Acknowledgements

The authors thank Elisabeth Friedel for her excellent assistance in the English translation of this manuscript.

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Authors and Affiliations

  1. Department for General, Visceral, Vascular and Paediatric Surgery, Saarland University Medical Center, Building 57, 66424, Homburg/Saar, Germany

    Clemens-Magnus Meier, Helge Latz & Matthias Glanemann

  2. Institute of Pathology, Saarland University Medical Center, Homburg/Saar, Germany

    Jens Kraemer

  3. Institute for Medical Biometry, Epidemiology and Medical Computer Science (IMBEI), Saarland University Medical Center, Homburg/Saar, Germany

    Stefan Wagenpfeil & Stefan Graeber

  4. Department for Paediatric Oncology and Haematology, Saarland University Medical Center, Homburg/Saar, Germany

    Arne Simon

Authors
  1. Clemens-Magnus Meier
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  2. Helge Latz
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  3. Jens Kraemer
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  4. Stefan Wagenpfeil
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  5. Stefan Graeber
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  6. Matthias Glanemann
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  7. Arne Simon
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Contributions

Clemens-Magnus Meier conceived of the study, was responsible for the study design, wrote the draft manuscript, and did parts of the statistics; Helge Latz collected the data, did parts of the statistics, contributed to, and reviewed the draft manuscript; Jens Kraemer was involved in histological grading, and participated in data interpretation; Stefan Wagenpfeil did parts of the statistics; Stefan Graeber did parts of the statistics; Matthias Glanemann reviewed the draft manuscript; Arne Simon participated in data interpretation, and reviewed the draft manuscript.

Corresponding author

Correspondence to Clemens-Magnus Meier.

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Funding

There is no funding of the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interests.

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All authors approved the final version of the manuscript.

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Meier, CM., Latz, H., Kraemer, J. et al. Acute appendicitis in children: can surgery be postponed? Short-term results in a cohort of 225 children. Langenbecks Arch Surg 402, 977–986 (2017). https://doi.org/10.1007/s00423-017-1607-4

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  • DOI: https://doi.org/10.1007/s00423-017-1607-4

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