Pediatric Acute Appendicitis: A Retrospective Evaluation of Multidisciplinary Management in Conservative and Surgical Treatment Approaches

Öz

Aim: To evaluate the outcomes of conservative and surgical treatment approaches in pediatric acute appendicitis within a multidisciplinary management framework. Methods: This retrospective, single-center study included 312 pediatric patients (0–18 years) diagnosed with acute appendicitis between January 2015 and January 2025. Patients were categorized into conservative (antibiotic therapy) and surgical (open or laparoscopic appendectomy) groups. Demographic, clinical, laboratory, and outcome data were analyzed. Multivariate logistic regression was used to identify predictors of complicated appendicitis. Results: Of the patients, 71.8% underwent surgical treatment and 28.2% were managed conservatively. The conservative group had a significantly shorter symptom duration and lower inflammatory markers (p<0.001). Treatment success in the conservative group was 84.1%, with a failure rate of 15.9%. Complication rates and hospital stay were higher in the surgical group (p=0.01 and p<0.001, respectively), likely reflecting higher disease severity. Symptom duration >24 hours, CRP >50 mg/L, and rebound tenderness were identified as independent predictors of complicated appendicitis. Conclusion: Both conservative and surgical approaches are effective in pediatric acute appendicitis when guided by appropriate patient selection. Multidisciplinary evaluation and clinical severity markers play a key role in optimizing treatment strategies and improving outcomes.

Anahtar Kelimeler

• Pediatric appendicitis
• Conservative management
• Appendectomy
• Multidisciplinary approach
• Complicated appendicitis

Destekleyen Kurum

NONE

Etik Beyan

Ethical approval was obtained from the Non-Interventional Clinical Research Ethics Committee of Van Yüzüncü Yıl University on 13/03/2026, with decision number 2026/03-54.

Teşekkür

none

Pediatrik Akut Apandisit: Konservatif ve Cerrahi Tedavi Yaklaşımlarında Multidisipliner Yönetimin Retrospektif Değerlendirilmesi

Öz

Özet Amaç: Bu çalışmada, pediatrik akut apandisit olgularında konservatif ve cerrahi tedavi yaklaşımlarının multidisipliner yönetim çerçevesinde klinik sonuçlarının değerlendirilmesi amaçlandı. Yöntemler: Bu retrospektif, tek merkezli çalışmaya Ocak 2015 ile Ocak 2025 tarihleri arasında akut apandisit tanısı alan 0–18 yaş aralığındaki 312 pediatrik hasta dahil edildi. Hastalar konservatif (antibiyotik tedavisi) ve cerrahi (açık veya laparoskopik appendektomi) tedavi gruplarına ayrıldı. Demografik, klinik, laboratuvar ve sonuç verileri analiz edildi. Komplike apandisiti öngören faktörleri belirlemek amacıyla çok değişkenli lojistik regresyon analizi kullanıldı. Bulgular: Hastaların %71.8’i cerrahi, %28.2’si konservatif tedavi ile yönetildi. Konservatif grupta semptom süresi ve inflamatuvar belirteçler anlamlı olarak daha düşüktü (p<0.001). Konservatif tedavi başarı oranı %84.1, başarısızlık oranı %15.9 olarak bulundu. Komplikasyon oranı ve hastanede kalış süresi cerrahi grupta daha yüksekti (sırasıyla p=0.01 ve p<0.001) ve bu durum daha yüksek hastalık şiddeti ile ilişkiliydi. Semptom süresinin 24 saatten uzun olması, CRP >50 mg/L ve rebound hassasiyet varlığı komplike apandisit için bağımsız risk faktörleri olarak saptandı. Sonuç: Pediatrik akut apandisit yönetiminde, uygun hasta seçimi ile hem konservatif hem de cerrahi tedavi yaklaşımları etkili bir şekilde uygulanabilir. Multidisipliner değerlendirme ve klinik şiddet belirteçleri, tedavi stratejisinin belirlenmesinde ve klinik sonuçların iyileştirilmesinde kritik rol oynamaktadır.

Anahtar Kelimeler

• Pediatrik apandisit
• Konservatif tedavi
• Appendektomi
• Multidisipliner yaklaşım
• Komplike apandisit

Destekleyen Kurum

YOK

Etik Beyan

Etik onay, 13/03/2026 tarih ve 2026/03-54 karar numarası ile Van Yüzüncü Yıl Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’ndan alınmıştır.

Teşekkür

yok

Kaynakça

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