Elective interval appendectomy following non-operative management for uncomplicated acute appendicitis: a feasible same-day discharge strategy in children.

Authors

Ryoichi Abiko, Hiroki Goto, Ayaka Fukada, Taishi Iwakami, Masahiro Shimizu, Yuki Yoneda, Yoshimasa Motoyama, Joel Cazares, Hiroyuki Koga, Masayuki Kitajima, Ai Futagawa, Yasushi Innami, Yasuhiro Okada, Todd Ponsky, Yuichi Nagakawa, Naoki Ohashi, Atsuyuki Yamataka

Published in

Pediatric surgery international. Volume 42. Issue 1. Jul 03, 2026. Epub Jul 03, 2026.

Abstract

Reliable predictors of recurrence after non-operative management (NOM) for pediatric uncomplicated acute appendicitis (UCAA) are lacking. Patients and families often face uncertainty and anxiety about recurrence. We evaluated elective interval appendectomy (E-IA) after NOM, focusing on same-day discharge (SDD).
We retrospectively reviewed patients aged ≤ 18 years who underwent laparoscopic E-IA after successful NOM for UCAA between 2017 and 2025. UCAA was defined as ultrasound grade I/IIa appendicitis without perforation, abscess, or diffuse peritonitis. Characteristics, perioperative outcomes, histopathology, and patient/family and staff satisfaction were analyzed.
A total of 120 patients underwent E-IA (SDD, n = 40; inpatient management, n = 80). Median age was 13.0 years; fecalith was present in 25 patients (20.8%). Median interval from scheduling to surgery was 48.5 days and operative time was 38.0 min. Complications occurred in 3 patients (2.5%), with no unplanned visits or readmissions. SDD was successful in 39/40 patients (97.5%). Recurrence before E-IA occurred in 5 patients (4.2%); all improved with repeat NOM and underwent E-IA. Patient/family and staff satisfaction were 83.3% and 89.3%, respectively. All specimens showed either acute inflammatory findings or chronic/resolving reparative changes, with none classified as histologically normal.
E-IA after NOM for UCAA was associated with low morbidity and SDD feasibility, suggesting a potentially new treatment concept for UCAA.

PMID:
42397443
Bibliographic data and abstract were imported from PubMed on 03 Jul 2026.

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