{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:34:14Z","timestamp":1787164454007,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T00:00:00Z","timestamp":1632700800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T00:00:00Z","timestamp":1632700800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T00:00:00Z","timestamp":1632700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The aim of this study is to investigate the outcomes of conservative management of non\u2010complicated acute appendicitis (AA) using our unique institutional protocol, and to compare between these and the outcomes of operative management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients admitted to our institution between March 2016 and October 2019 with non\u2010complicated AA were grouped according to their initial management: non\u2010operative versus surgical. Our unique protocol for non\u2010operative management includes: pain &lt;\u20093\u00a0days; afebrile upon admission; non\u2010gravid; WBC &lt;15,000 (\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L); CRP &lt;\u20095\u00a0mg\/dl; appendix diameter\u2009&lt;\u20091\u00a0cm; no appendicolith on imaging; no prior episode of AA; no history of Inflammatory Bowel Disease; no evidence of peritonitis on physical examination. The primary outcome measured was failure of non\u2010surgical management during the index admission. Secondary outcomes included recurrence rate, readmissions, complications, length of antibiotic treatment and length of stay (LOS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 695 patients were included, 436\u00a0in the operative group and 259\u00a0in the non\u2010surgical treatment group. The mean follow\u2010up time was 1004.9\u2009\u00b1\u2009205.7\u00a0days. Patients initially treated conservatively rarely required surgery during their index admission (6.9%). Recurrence rate was 19.1% after a mean follow up of 33.4\u00a0months. The overall failure rate of conservative management was documented in 20.8% of the patients. The complication rate was higher in those treated with upfront surgery (1.6% vs. 0.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The overall LOS was not statistically different between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our composite protocol for non\u2010surgical management of non\u2010complicated AA results in a low failure rate. A well calculated patient treatment allocation in non\u2010complicated AA can advocate for wide\u2010spread use of the conservative approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-021-06330-x","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T09:05:18Z","timestamp":1632733518000},"page":"69-75","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Composite Criteria for Non\u2010Operative Management of Acute Non\u2010Complicated Appendicitis Result in Low Failure Rates"],"prefix":"10.1002","volume":"46","author":[{"given":"Shahaf","family":"Shay","sequence":"first","affiliation":[{"name":"Department of Surgery Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8624-4492","authenticated-orcid":false,"given":"Amram","family":"Kupietzky","sequence":"additional","affiliation":[{"name":"Department of Surgery Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Joshua","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Surgery Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roi","family":"Dover","sequence":"additional","affiliation":[{"name":"Department of Surgery Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nachum Emil Eliezer","family":"Lourie","sequence":"additional","affiliation":[{"name":"Department of Surgery Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzlil","family":"Mordechay\u2010Heyn","sequence":"additional","affiliation":[{"name":"Department of Surgery Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haggi","family":"Mazeh","sequence":"additional","affiliation":[{"name":"Department of Surgery Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ido","family":"Mizrahi","sequence":"additional","affiliation":[{"name":"Department of Surgery Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem Jerusalem 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