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<https://discovery.ucl.ac.uk/id/eprint/1529248> <http://purl.org/dc/terms/title> "Efficacy and safety of non-operative treatment for acute appendicitis: a meta-analysis"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/eprint/1529248> <http://purl.org/ontology/bibo/abstract> "CONTEXT: Non-operative treatment (NOT) with antibiotics alone of acute uncomplicated appendicitis (AUA) in children has been proposed as an alternative to appendicectomy.\r\nOBJECTIVE: To determine safety and efficacy of NOT based on current literature.\r\nDATA SOURCES: Three electronic databases.\r\nSTUDY SELECTION: All articles reporting NOT for AUA in children.\r\nDATA EXTRACTION: Two reviewers independently verified study inclusion and extracted data.\r\nRESULTS: Ten articles reporting 413 children receiving NOT were included. Six, including one RCT, compared NOT with appendicectomy. The remaining four reported outcomes of children receiving NOT without a comparison group. NOT was effective as the initial treatment in 97% of children (95%CI 96, 99). Initial length of hospital stay was shorter in children treated with appendectomy compared to NOT (mean difference 0.5 days [95%CI 0.2, 0.8]; p=0.002). At final reported follow-up (range 8 weeks – 4 years), NOT remained effective (no appendicectomy performed) in 79% of children (95%CI 73, 86%). Recurrent appendicitis occurred in 14% (95%CI 7, 21). Complications, and total length\r\nof hospital stay during follow-up were similar for NOT and appendicectomy. No serious adverse events related to NOT were reported.\r\nLIMITATIONS: The lack of prospective randomised studies limits definitive conclusions to influence clinical practice.\r\nCONCLUSIONS: Current data suggest that NOT is safe. It appears effective as initial treatment in 97% of children with AUA and the rate of recurrent appendicitis is 14%.\r\nLonger term clinical outcomes and cost effectiveness of NOT compared to appendicectomy require further evaluation, preferably as large randomised trials to reliably inform decision making."^^<http://www.w3.org/2001/XMLSchema#string> .
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