TY  - JOUR
IS  - 3
N1  - This version is the author-accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
TI  - Non-operative Versus Operative Management of Perianal Abscess in Infants: A 10-year Retrospective Study at Two Centres in the United Kingdom
AV  - restricted
Y1  - 2025/03//
VL  - 60
JF  - Journal of Pediatric Surgery
A1  - Neville, JJ
A1  - Humpleby, K
A1  - Healy, C
A1  - Hall, NJ
A1  - Stanton, MP
KW  - Fistula-in-ano
KW  -  Infant
KW  -  Paediatric surgery
KW  -  Perianal abscess
N2  - Background:
Perianal abscess (PA), with or without fistula-in-ano (FIA) is common in infants. Treatment options include incision and drainage under general anaesthesia or non-operative treatments, such as antibiotics and/or aspiration under local anaesthetic, which avoid the risks of surgery. Current management is based on surgeon preference due to a poor underlying evidence base. In this study we aimed to compare outcomes for non-operative and operative management of infant PA.//

Methods:
10-year retrospective review (2012?2022) of infants aged ?12 months presenting with PA to two paediatric surgery centres in the United Kingdom. Clinical features, management and outcome data were extracted from electronic records.//
Results:
116 infants were identified; 113/116 (97 %) were male. Median age at presentation was 2 (IQR 1?6) months. Initial management was non-operative in 73/116 (63 %) and operative in 43/80 (37 %). Median follow-up was 3 (IQR 2?6) months. Recurrence occurred in 49/116 (42 %) at a median time of 1 (IQR 0?3) month and was significantly higher in the non-operative compared to the operative group (39/73 [53 %] versus 10/43 [23 %], p = 0.001). Operative management was independently associated with a reduced risk of PA recurrence (OR 0.25 [95 % confidence interval 0.09?0.68], p = 0.007). Further surgery was performed in 26/73 (36 %) in the non-operative group and 7/43 (16 %) in the operative group (p = 0.026). Subsequent FIA rates were not significantly different (23/73 [32 %] versus 8/43 [19 %], p = 0.129).//
Conclusions:
In this study, PA recurrence and the requirement for further operative intervention were significantly higher when a PA was initially managed non-operatively, although subsequent FIA rates were similar.
ID  - discovery10204879
UR  - https://doi.org/10.1016/j.jpedsurg.2024.162101
PB  - Elsevier BV
SN  - 0022-3468
ER  -