{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:53:02Z","timestamp":1790934782147,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This systematic review with meta\u2010analysis aims to evaluate the current evidence comparing antibiotic therapy with the surgical gold standard (appendectomy) for the treatment of uncomplicated acute appendicitis (UAA) in children and adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis followed PRISMA guidelines and was registered in PROSPERO, CRD420251011305. MEDLINE and CENTRAL were systematically searched up to March 2025. Randomized controlled trials (RCTs) comparing antibiotic therapy and appendectomy in patients aged 0\u201318\u00a0years with UAA were included. Summary data were extracted from published reports of eligible RCTs. Full text eligibility and data extraction were performed independently by two reviewers. Primary outcome was the complication\u2010free treatment success rate at 30\u00a0days. Secondary outcomes included recurrence and complicated appendicitis at surgery. Risk ratios (RR) with 95% CIs were calculated using a random effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 815 records screened, six studies met inclusion criteria and were included in the review. A clinically relevant difference emerged in terms of complication\u2010free treatment success between the two groups (1333 participants; RR 0.90, 95% CI 0.84\u20130.96;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      63%; and moderate certainty of evidence) favoring surgical management over antibiotic therapy among the five studies included in the meta\u2010analysis. Recurrence after successful NOM occurred in 6%\u201324% of patients at 1\u00a0year\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Antibiotic therapy could represent a feasible treatment option for UAA in children and adolescents, although in terms of complication\u2010free treatment success, appendectomy remains the gold standard.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>CRD420251011305<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70439","type":"journal-article","created":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T16:04:02Z","timestamp":1780848242000},"page":"1962-1973","source":"Crossref","is-referenced-by-count":2,"title":["Nonoperative Management of Uncomplicated Acute Appendicitis: A Systematic Review and Meta\u2010Analysis of Randomized Clinical Trials Comparing Antibiotic Treatment and Appendectomy in Children and Adolescents"],"prefix":"10.1002","volume":"50","author":[{"given":"Eleonora","family":"Allocati","sequence":"first","affiliation":[{"name":"Istituto di Ricerche Farmacologiche \u201cMario Negri\u201d IRCCS  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Gerardi","sequence":"additional","affiliation":[{"name":"Istituto di Ricerche Farmacologiche \u201cMario Negri\u201d IRCCS  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7935-3842","authenticated-orcid":false,"given":"Marco","family":"Ceresoli","sequence":"additional","affiliation":[{"name":"General and Emergency Surgery Fondazione IRCCS San Gerardo dei Tintori  Monza Italy"},{"name":"School of Medicine and Surgery Milano\u2010Bicocca University  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulina","family":"Salminen","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Turku  Turku Finland"},{"name":"Division of Digestive Surgery Turku University Hospital  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Starinieri","sequence":"additional","affiliation":[{"name":"Istituto di Ricerche Farmacologiche \u201cMario Negri\u201d IRCCS  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Podda","sequence":"additional","affiliation":[{"name":"Department of Surgical Science University of Cagliari  Cagliari 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