Risk factors for surgical difficulty in interval appendectomy for perforated appendicitis with abscess in children.

IF 1.6 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2025-08-19 DOI:10.1007/s00383-025-06157-w

Keisuke Suzuki, Chizuka Seki, Tsubasa Goshima, Mina Yoshida, Yuta Nakashima, Yuki Shiko, Maiko Osawa, Yohei Kawasaki, Yujiro Tanaka

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Abstract

Purpose: To predict surgical difficulty during interval appendectomy for perforated appendicitis with abscess.

Methods: The records of children diagnosed with appendiceal abscess who underwent interval appendectomy from 2012 to 2024 were reviewed. The clinical data associated with difficult surgeries (operative time > 2 h or addition of trocars) and uncomplicated surgeries were compared.

Results: Among the 61 children who underwent interval appendectomy, 42 had uncomplicated surgery, whereas 19 children had difficult surgery. Children who underwent difficult surgery were older (11.5 ± 3 vs. 8.8 ± 3 years, p = 0.001), taller (p = 0.009), and weighed more (p = 0.011) compared to those who had uncomplicated surgery. In addition, difficult surgery was associated with larger abscesses (p = 0.003) and longer initial hospital stay (p = 0.046). Multivariate analysis identified older age (OR = 1.36; 95% CI = 1.08-1.8; p = 0.017), longer abscess diameter (OR = 1.36; 95% CI = 0.96-2.02; p = 0.097), and longer initial hospital stay (OR = 1.03; 95% CI = 1-1.07; p = 0.097) as possible risk factors for difficult surgery. According to ROC analysis, the cut-off values of age, abscess diameter, and length of hospital stay for predicting complicated appendectomy were 10.4 years, 5.8 cm, and 16.5 days, respectively.

Conclusion: Older age, larger abscesses, and longer hospital stay for non-operative treatment may contribute to increased surgical difficulty during interval appendectomy.

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儿童穿孔性阑尾炎伴脓肿间歇切除术手术困难的危险因素分析。

目的：预测穿孔性阑尾炎合并脓肿间歇切除术的手术难度。方法：回顾性分析2012 ~ 2024年诊断为阑尾脓肿的患儿行间歇阑尾切除术的资料。比较困难手术（手术时间bbb2h或添加套管针）和简单手术的临床资料。结果：61例患儿行间歇阑尾切除术，42例手术简单，19例手术困难。接受困难手术的儿童年龄较大（11.5±3岁比8.8±3岁，p = 0.001），身高较高（p = 0.009），体重较轻（p = 0.011）。此外，困难的手术与较大的脓肿（p = 0.003）和较长的初次住院时间（p = 0.046）相关。多因素分析发现，年龄较大（OR = 1.36; 95% CI = 1.08-1.8; p = 0.017）、脓肿直径较大（OR = 1.36; 95% CI = 0.96-2.02; p = 0.097）、初次住院时间较长（OR = 1.03; 95% CI = 1-1.07; p = 0.097）是手术困难的可能危险因素。根据ROC分析，预测复杂阑尾切除术的年龄、脓肿直径和住院时间的截止值分别为10.4年、5.8 cm和16.5天。结论：年龄较大、脓肿较大、非手术治疗住院时间较长可能增加间歇阑尾切除术的手术难度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor