Management of complicated acute appendicitis in children:Still an existing controversy  

作　　者：Nick Zavras George Vaos 

机构地区：[1]Department of Paediatric Surgery,“ATTIKON”University General Hospital,National and Kapodistrian University of Athens,School of Medicine,Athens 12462,Greece

出　　处：《World Journal of Gastrointestinal Surgery》2020年第4期129-137,共9页世界胃肠外科杂志（英文版）（电子版）

摘　　要：Complicated acute appendicitis(CAA)is a serious condition and carries significant morbidity in children.A strict diagnosis is challenging,as there are many lesions that mimic CAA.The management of CAA is still controversial.There are two options for treatment:Immediate operative management and nonoperative management with antibiotics and/or drainage of any abscess or phlegmon.Each method of treatment has advantages and disadvantages.Operative management may be difficult due to the presence of inflamed tissues and may lead to detrimental events.In many cases,non-operative management with or without drainage and interval appendectomy is advised.The reasons for this approach include new medications and policies for the use of antibiotic therapy.Furthermore,advances in radiological interventions may overcome difficulties such as diagnosing and managing the complications of CAA without any surgeries.However,questions have been raised about the risk of recurrence,prolonged use of antibiotics,lengthened hospital stay and delay in returning to daily activities.Moreover,the need for interval appendectomy is currently under debate because of the low risk of recurrence.Due to the paucity of high-quality studies,more randomized controlled trials to determine the precise management strategy are needed.This review aims to study the current data on operative vs non-operative management for CAA in children and to extract any useful information from the literature.

关 键 词：COMPLICATED acute APPENDICITIS OPERATIVE TREATMENT NON-OPERATIVE TREATMENT Antibiotics CHILDREN 

分 类 号：R726.5[医药卫生—儿科]