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Early Appendectomy Scores Over Interval Appendectomy

by Dr. Trupti Shirole on February 22, 2011 at 8:17 PM
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 Early Appendectomy Scores Over Interval Appendectomy

Every year about 80,000 children in the US undergo appendectomies making it the most common surgical procedure among kids. A new study by the University of Tennessee Health Science Center in Memphis has revealed that for children with perforated appendix early appendectomy is better as children could return to routine activities like school and sports an average 6-days earlier.

The two common surgical options for children with a perforated appendix are early appendectomy (surgical removal of appendix within 24hours) and interval appendectomy (surgical removal of appendix after 6-8weeks of initial diagnosis). So far it was believed that the chances of infection in interval appendectomy are less as it allows the contamination in the peritoneal cavity to resolve. However the new study has found that early appendectomy was linked to fewer complications like infection of the surgical site and intra-abdominal abscess.

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The team studied the results of 131 patients below 18-years of age, who were diagnosed with appendicitis and a perforated appendix. 64 children were advised early appendectomy, while remaining 67 were advised interval appendectomy on random basis. The study revealed that in case of early appendectomy children could return to normal routine activities within 14days, while this duration was 19-days for children who were assigned for interval appendectomy. The chances of complications were 30% for early appendectomy and 55% for interval appendectomy.

However, chief of pediatric surgery at Cohen Children's Medical Center of New York, Dr. Steve Dolgin said, "The child with a perforated appendix requires treatment with antibiotics. The timing of an appendectomy does not need to be immediate. Some children with advanced appendicitis do better if they are treated with antibiotics and no operation during the acute illness. This new study does not answer this question (of when to operate) but adds to the debate. The best way to help children with appendicitis is to make the diagnosis early, before the appendix perforates."

Source: Medindia
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