Early versus interval appendectomy in children with complicated appendicitis: effects on hospital stay and occurrence of severe complications

Schmidt, Yannick; Cramer, Franziska; Muensterer, Oliver J. ; Wendling-Keim, Danielle S. (2026): Early versus interval appendectomy in children with complicated appendicitis: effects on hospital stay and occurrence of severe complications. Frontiers in Pediatrics, 14: 1788720. ISSN 2296-2360

Abstract

Purpose:

Acute appendicitis is a common pediatric emergency, yet optimal management of complicated cases remains debated. This study compares outcomes of early vs. interval appendectomy in children with perforated appendicitis.

Methods:

A retrospective review of 254 patients (<18 years) treated between January 2012 and December 2023 was conducted. Twenty-two underwent interval appendectomy, and 232 underwent early appendectomy. Demographic and clinical data were analyzed using SPSS v29.0.1.0, with statistical significance defined as p < 0.05.

Results:

Early appendectomy was associated with a significantly shorter cumulative hospital stay (mean 9.2 days) than interval appendectomy (mean 22.5 days; p < 0.001). Overall complication rates were higher in the interval group (10/22) compared to the early group (31/232; p < 0.001). However, severe complications, such as ileostomy creation, stump insufficiency, and ileocecal pole resection, occurred exclusively in the early appendectomy group.

Conclusion:

Early appendectomy in children with complicated appendicitis results in shorter hospitalization and fewer overall complications but carries a risk of more severe postoperative events. Prospective studies are warranted to refine patient selection and optimize treatment strategies.

• Doc-Type: Article (LMU Hospital)
• Organisational unit (Faculties): 07 Medicine > Medical Center of the University of Munich > Pediatric Clinic and Outpatient Clinic in the Dr. von Hauner Children‘s Hospital
• DFG subject classification of scientific disciplines: Life sciences
• DFG: Funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) - 491502892