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Association of nonoperative management using antibiotic therapy vs laparoscopic appendectomy with treatment success and disability days in children with uncomplicated appendicitis

JAMA Jul 30, 2020

Minneci PC, Hade EM, Lawrence AE, et al. - In this nonrandomized controlled intervention study, which used propensity score weighting and included 1,068 children (median age, 12.4 years; 38% girls), researchers sought to determine the success rate of nonoperative management and to compare differences in treatment-related disability, satisfaction, health-related quality of life, and complications between nonoperative management and surgery in children with uncomplicated appendicitis. For children with uncomplicated appendicitis, an initial nonoperative antibiotic-only treatment approach had a success rate of 67.1% and was correlated with statistically significantly fewer disability days at 1 year compared with urgent surgery. However, there was a substantial follow-up loss, the comparison with the prespecified threshold for an acceptable success rate for nonoperative management was not statistically significant, and the hypothesized disability days difference was not met.

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