Aiming for minimally invasive treatment of pediatric acute appendicitis in a district hospital

Annals of Pediatric Surgery

Table 1 Clinical presentation of patients without surgery after antibiotic treatment: relapse (+) vs. relapse (−)

	Relapse (+)	Relapse (−)	p
n (boy/girl)	15 (12/3)	20 (8/12)	0.018
Age (years) (range)	12.6±1.2 (9-15)	11.4±1.3 (6-15)	0.95
WBC (×10³/μl) (range)	15.8±4.6 (7.5-25.0)	11.1±4.8 (4.1-26.4)	0.006
CRP (mg/dL) (range)	5.1±5.8 (0.1-20.8)	3.0±1.8 (0.9-6.5)	0.197
Appendix diameter (mm) (range)	10.3±3.2 (7-20)	7.8±2.0 (6-14)	0.007
Appendix diameter (≥10 mm)	9 (60%)	1 (5%)	<0.001
Pediatric appendicitis score (range)	6.3±1.1 (4-8)	4.4±1.8 (2-7)	<0.001
Length of hospital stay (day) (range)	7.4±3.0 (4-16)	4.4±3.5 (0-9)	0.015
Interval to relapse (day) (range)	99±51.1 (21-204)

WBC White blood cell, CRP C-reactive protein
Of the 35 patients who did not have surgery after antibiotic treatment, there were significant differences in WBC counts [relapse (+): 15.8 ×10³/μl vs. relapse (−): 11.1 ×10³/μl (p=0.006)], appendix diameter [relapse (+): 10.3 mm vs. relapse (−): 7.8 mm (p=0.007)] and pediatric appendicitis score [relapse (+): 6.3 vs. relapse (−): 4.4 (p<0.001)] between the two groups of patients with and without relapse. There was also a significant difference in LOS between the two groups [relapse (+): 7.4 days vs. relapse (−): 4.4 days (p=0.015)]. Setting a cutoff value of 10 mm, the relapse group had a significantly higher percentage of cases with appendix diameters ≥10 mm than the non-relapse group [9/15 (60%) vs. 1/20 (5%); p<0.001]