Puapong Devin, Lee Steven L, Haigh Philip I, Kaminski Anna, Liu In-Lu Amy, Applebaum Harry
Division of Pediatric Surgery and Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA 90027, USA.
J Pediatr Surg. 2007 Sep;42(9):1500-3. doi: 10.1016/j.jpedsurg.2007.04.011.
This study evaluates outcomes for children treated without interval appendectomy (IA) after successful nonoperative management of perforated appendicitis.
A retrospective study of pediatric patients with appendicitis was performed from 12 regional acute-care hospitals from 1992 to 2004 with mean length of follow-up of 7.5 years. Main outcomes were recurrent appendicitis and cumulative length of hospital stay.
The study included 6439 patients, of which 6367 (99%) underwent initial appendectomy. Seventy-two (1%) patients were initially managed nonoperatively and 11 patients had IA. Of the remaining 61 patients without IA, 5 (8%) developed recurrent appendicitis. Age, sex, type of appendicitis, and abscess drainage had no influence on recurrent appendicitis. Cumulative length of hospital stay was 6.6 days in patients without IA, 8.5 days in patients with IA, and 9.6 days in patients with recurrent appendicitis.
Recurrent appendicitis is rare in pediatric patients after successful nonoperative management of perforated appendicitis. Routine IA is not necessarily indicated for these children.
本研究评估了穿孔性阑尾炎非手术治疗成功后未行间隔期阑尾切除术（IA）的儿童的治疗结果。
对1992年至2004年期间来自12家地区急症医院的阑尾炎患儿进行了一项回顾性研究，平均随访时间为7.5年。主要结局为复发性阑尾炎和累计住院时间。
该研究纳入6439例患者，其中6367例（99%）接受了初次阑尾切除术。72例（1%）患者最初接受非手术治疗，11例患者接受了IA。在其余61例未接受IA的患者中，5例（8%）发生了复发性阑尾炎。年龄、性别、阑尾炎类型和脓肿引流对复发性阑尾炎无影响。未接受IA的患者累计住院时间为6.6天，接受IA的患者为8.5天，复发性阑尾炎患者为9.6天。
穿孔性阑尾炎非手术治疗成功后，小儿复发性阑尾炎很少见。这些儿童不一定需要常规行IA。
