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The clinical data associated with difficult surgeries (operative time\u2009&gt;\u20092\u00a0h or addition of trocars) and uncomplicated surgeries were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 61 children who underwent interval appendectomy, 42 had uncomplicated surgery, whereas 19 children had difficult surgery. Children who underwent difficult surgery were older (11.5\u2009\u00b1\u20093 vs. 8.8\u2009\u00b1\u20093\u00a0years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), taller (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), and weighed more (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011) compared to those who had uncomplicated surgery. In addition, difficult surgery was associated with larger abscesses (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and longer initial hospital stay (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046). Multivariate analysis identified older age (OR\u2009=\u20091.36; 95% CI\u2009=\u20091.08\u20131.8;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017), longer abscess diameter (OR\u2009=\u20091.36; 95% CI\u2009=\u20090.96\u20132.02;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.097), and longer initial hospital stay (OR\u2009=\u20091.03; 95% CI\u2009=\u20091\u20131.07;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.097) as possible risk factors for difficult surgery. According to ROC analysis, the cut-off values of age, abscess diameter, and length of hospital stay for predicting complicated appendectomy were 10.4\u00a0years, 5.8\u00a0cm, and 16.5\u00a0days, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Older age, larger abscesses, and longer hospital stay for non-operative treatment may contribute to increased surgical difficulty during interval appendectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00383-025-06157-w","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T16:19:07Z","timestamp":1755620347000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk factors for surgical difficulty in interval appendectomy for perforated appendicitis with abscess in children"],"prefix":"10.1007","volume":"41","author":[{"given":"Keisuke","family":"Suzuki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chizuka","family":"Seki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsubasa","family":"Goshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Nakashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Shiko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maiko","family":"Osawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohei","family":"Kawasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujiro","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"issue":"11","key":"6157_CR1","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1111\/jpc.13737","volume":"53","author":"MD Stringer","year":"2017","unstructured":"Stringer MD (2017) Acute appendicitis. 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