2017
DOI: 10.1001/jamapediatrics.2017.0057
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Comparison of Antibiotic Therapy and Appendectomy for Acute Uncomplicated Appendicitis in Children

Abstract: IMPORTANCE Antibiotic therapy for acute uncomplicated appendicitis is effective in adult patients, but its application in pediatric patients remains controversial.OBJECTIVE To compare the safety and efficacy of antibiotic treatment vs appendectomy as the primary therapy for acute uncomplicated appendicitis in pediatric patients. DATA SOURCESThe PubMed, MEDLINE, EMBASE, and Cochrane Library databases and the Cochrane Controlled Trials Register for randomized clinical trials were searched through April 17, 2016.… Show more

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Cited by 196 publications
(173 citation statements)
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“…Si se combinaban los cuatro procedimientos en una categoría, el promedio alcanzaba un 84%. Pero ante procedimientos como la apendicectomía o colectomía complicada, los residentes fueron competentes en un nivel mucho más bajo [182][183][184] . Esto podría estar significando que, si bien necesitamos más cirujanos, el producto final no está siendo el más adecuado, lo que llevaría a incrementar el número de años en la residencia.…”
Section: La Tecnología Y La Humanizaciónunclassified
“…Si se combinaban los cuatro procedimientos en una categoría, el promedio alcanzaba un 84%. Pero ante procedimientos como la apendicectomía o colectomía complicada, los residentes fueron competentes en un nivel mucho más bajo [182][183][184] . Esto podría estar significando que, si bien necesitamos más cirujanos, el producto final no está siendo el más adecuado, lo que llevaría a incrementar el número de años en la residencia.…”
Section: La Tecnología Y La Humanizaciónunclassified
“…It is also interesting to compare the current meta-analysis4 with that published by Huang et al 8 in May 2017. Both meta-analyses review five studies, with four of these being identical between the two studies.…”
mentioning
confidence: 92%
“…The latter meta-analysis8 includes a prospective study of non-operative management of children with uncomplicated acute appendicitis associated with an appendicolith,9 with the study being halted early due to an unacceptably high failure rate (60% at median follow-up of 4.7 months). Overall, this meta-analysis8 found non-operative management to be successful in 90.5% (n=152 of 168) at 1-month follow-up and concludes that ‘antibiotics as the initial treatment for p(a)ediatric patients with uncomplicated appendicitis may be feasible and effective’. However, when recurrence of appendicitis at 1-year follow-up was considered, 26.8% (45 patients) underwent a subsequent appendicectomy.…”
mentioning
confidence: 99%
“…Therefore, the necessity of an appendectomy is being challenged and non-operative treatment (NOT) of uncomplicated appendicitis in children is gaining ground. Recently five systematic reviews [13, 15, 19, 21, 42] were published, including 13 studies with a total of 808 children treated non-operatively. The included study designs comprise retrospective studies, prospective cohort studies, and one pilot randomized controlled trial (RCT).…”
Section: Introductionmentioning
confidence: 99%
“…In contrast to patients treated surgically, who are considered to be fully recovered the following day. This call for more information on clinical recovery is also reflected in the editorial commentaries [7, 18, 25, 27] following the systematic review by Huang et al [19]. The authors stress the need for higher-level evidence with larger pediatric patient groups and preferably randomized or patient preference designs.…”
Section: Introductionmentioning
confidence: 99%