{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T04:00:37Z","timestamp":1794628837083,"version":"4.9.1"},"reference-count":58,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Surg Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This review summarizes considerations within the existing recent literature that guide the practice of interval appendectomy (IA) after initial non-operative management (NOM) of complicated appendicitis (CA) in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review of English language articles published from 2000 to 2025 was conducted in Medline, Embase, and Cochrane Central Register of Controlled Trials to address four elements which could impact the decision for IA after NOM of CA: (1) the incidence of recurrent appendicitis; (2) the time period in which recurrence occurs; (3) the patient or disease-related risk factors which increase recurrence; and (4) the incidence of appendiceal neoplasms identified by IA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 3,022 articles initially reviewed, 46 met inclusion criteria. Recurrence was reported in 2\u201350% of patients. When IA is pursued, the optimal timing remains undefined, although evidence suggests most recurrences occur within three to six months, so there may be potential benefit to performing IA within three months after the initial presentation. Risk factors for recurrent appendicitis are not well characterized, though the presence of an appendicolith may increase recurrence risk. Across studies, the incidence of appendiceal neoplasms was rare, with most studies not documenting any cases; all reported neoplasms were neuroendocrine tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current evidence does not favor any single approach to IA, including routine IA, selective IA, or indefinite NOM; rather a shared-decision ought to be made between the surgeon and patient\u2019s caregivers. Utilization and timing of IA must balance surgical risks with the risk of recurrent disease; however, the risk of neoplasm should not primarily drive management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>I\u2212IIV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00383-026-06445-z","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T09:22:24Z","timestamp":1777281744000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Interval appendectomy practices for complicated appendicitis in children: a systematic review from the APSA Outcomes and Evidence-Based Practice Committee"],"prefix":"10.1007","volume":"42","author":[{"given":"Jason P.","family":"Sulkowski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos T.","family":"Huerta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Tashiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana L.","family":"Diesen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Gulack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Christison-Lagay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie W.","family":"Russell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Alemayehu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie F.","family":"Polites","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew T.","family":"Hey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry L.","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alana L.","family":"Beres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romeo C.","family":"Ignacio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald J.","family":"Lucas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra K.","family":"Kabagambe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Baird","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afif N.","family":"Kulaylat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara A.","family":"Mansfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca M.","family":"Rentea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Pennell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barrie S.","family":"Rich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmine","family":"Yousef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Ricca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Kelley-Quon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar L.","family":"Levene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"6445_CR1","doi-asserted-by":"publisher","first-page":"1977","DOI":"10.1001\/JAMA.292.16.1977","volume":"292","author":"TA Ponsky","year":"2004","unstructured":"Ponsky TA, Huang ZJ, Kittle K et al (2004) Hospital- and patient-level characteristics and the risk of appendiceal rupture and negative appendectomy in children. JAMA 292:1977\u20131982. https:\/\/doi.org\/10.1001\/JAMA.292.16.1977","journal-title":"JAMA"},{"key":"6445_CR2","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1016\/j.jpeds.2004.02.029","volume":"144","author":"SL Guthery","year":"2004","unstructured":"Guthery SL, Hutchings C, Dean JM, Hoff C (2004) National estimates of hospital utilization by children with gastrointestinal disorders: Analysis of the 1997 kids\u2019 inpatient database. J Pediatr 144:589\u2013594. https:\/\/doi.org\/10.1016\/j.jpeds.2004.02.029","journal-title":"J Pediatr"},{"key":"6445_CR3","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1053\/j.sempedsurg.2016.05.002","volume":"25","author":"DO Gonzalez","year":"2016","unstructured":"Gonzalez DO, Deans KJ, Minneci PC (2016) Role of non-operative management in pediatric appendicitis. Semin Pediatr Surg 25:204\u2013207. https:\/\/doi.org\/10.1053\/j.sempedsurg.2016.05.002","journal-title":"Semin Pediatr Surg"},{"key":"6445_CR4","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1007\/S00464-024-10813-Y","volume":"38","author":"SS Kumar","year":"2024","unstructured":"Kumar SS, Collings AT, Lamm R et al (2024) SAGES guideline for the diagnosis and treatment of appendicitis. Surg Endoscopy 2024 38:6. https:\/\/doi.org\/10.1007\/S00464-024-10813-Y","journal-title":"Surg Endoscopy 2024"},{"key":"6445_CR5","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.jclinepi.2016.01.021","volume":"75","author":"J McGowan","year":"2016","unstructured":"McGowan J, Sampson M, Salzwedel DM et al (2016) PRESS Peer Review of Electronic Search Strategies: 2015 Guideline Statement. J Clin Epidemiol 75:40\u201346. https:\/\/doi.org\/10.1016\/j.jclinepi.2016.01.021","journal-title":"J Clin Epidemiol"},{"key":"6445_CR6","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1089\/LAP.2021.0013","volume":"31","author":"Y Tian","year":"2021","unstructured":"Tian Y, Ingram MCE, Raval MV (2021) National Trends and Disparities in the Diffusion of Laparoscopic Surgery for Children in the United States. J Laparoendoscopic Adv Surg Techniques 31:1061\u20131066. https:\/\/doi.org\/10.1089\/LAP.2021.0013","journal-title":"J Laparoendoscopic Adv Surg Techniques"},{"key":"6445_CR7","doi-asserted-by":"publisher","unstructured":"Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339. https:\/\/doi.org\/10.1136\/BMJ.B2700","DOI":"10.1136\/BMJ.B2700"},{"key":"6445_CR8","doi-asserted-by":"publisher","first-page":"2242","DOI":"10.1016\/J.JPEDSURG.2008.08.051","volume":"43","author":"SD St. Peter","year":"2008","unstructured":"St. Peter SD, Sharp SW, Holcomb GW, Ostlie DJ (2008) An evidence-based definition for perforated appendicitis derived from a prospective randomized trial. J Pediatr Surg 43:2242\u20132245. https:\/\/doi.org\/10.1016\/J.JPEDSURG.2008.08.051","journal-title":"J Pediatr Surg"},{"key":"6445_CR9","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1046\/J.1445-2197.2003.02748.X","volume":"73","author":"K Slim","year":"2003","unstructured":"Slim K, Nini E, Forestier D et al (2003) Methodological index for non-randomized studies (Minors): Development and validation of a new instrument. ANZ J Surg 73:712\u2013716. https:\/\/doi.org\/10.1046\/J.1445-2197.2003.02748.X","journal-title":"ANZ J Surg"},{"key":"6445_CR10","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1089\/lap.2006.16.67","volume":"16","author":"J Bass","year":"2006","unstructured":"Bass J, Rubin S, Hummadi A (2006) Interval Appendectomy: An Old New Operation. J Laparoendosc Adv Surg Tech 16:67\u201369. https:\/\/doi.org\/10.1089\/lap.2006.16.67","journal-title":"J Laparoendosc Adv Surg Tech"},{"key":"6445_CR11","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1177\/000313481408000332","volume":"80","author":"CE Calvert","year":"2014","unstructured":"Calvert CE, Tracy S, Zhou J et al (2014) Treatment of perforated appendicitis in children: focus on phlegmon. Am Surg 80:314\u2013316","journal-title":"Am Surg"},{"key":"6445_CR12","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1136\/archdischild-2012-303400","volume":"99","author":"M Castello Gonzalez","year":"2014","unstructured":"Castello Gonzalez M, Bueno Rodriguez JC, Hernandez Moore E, Aguilar Atanay D (2014) Predictors of recurrent appendicitis after non-operative management of children with perforated appendicitis presenting with an appendicular inflammatory mass. Arch Dis Child 99:154\u2013157. https:\/\/doi.org\/10.1136\/archdischild-2012-303400","journal-title":"Arch Dis Child"},{"key":"6445_CR13","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.jss.2017.07.001","volume":"220","author":"JT Church","year":"2017","unstructured":"Church JT, Klein EJ, Carr BD, Bruch SW (2017) Early appendectomy reduces costs in children with perforated appendicitis. J Surg Res 220:119\u2013124. https:\/\/doi.org\/10.1016\/j.jss.2017.07.001","journal-title":"J Surg Res"},{"key":"6445_CR14","doi-asserted-by":"publisher","first-page":"1612","DOI":"10.1016\/j.jpedsurg.2005.06.001","volume":"40","author":"SH Ein","year":"2005","unstructured":"Ein SH, Langer JC, Daneman A (2005) Nonoperative management of pediatric ruptured appendix with inflammatory mass or abscess: presence of an appendicolith predicts recurrent appendicitis. J Pediatr Surg 40:1612\u20131615. https:\/\/doi.org\/10.1016\/j.jpedsurg.2005.06.001","journal-title":"J Pediatr Surg"},{"key":"6445_CR15","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1177\/000313480707300920","volume":"73","author":"S Emil","year":"2007","unstructured":"Emil S, Duong S (2007) Antibiotic therapy and interval appendectomy for perforated appendicitis in children: a selective approach. Am Surg 73:917\u2013922","journal-title":"Am Surg"},{"key":"6445_CR16","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/s00383-004-1334-0","volume":"21","author":"D Erdo\u011fan","year":"2005","unstructured":"Erdo\u011fan D, Karaman \u0130, Narc\u0131 A et al (2005) Comparison of two methods for the management of appendicular mass in children. Pediatr Surg Int 21:81\u201383. https:\/\/doi.org\/10.1007\/s00383-004-1334-0","journal-title":"Pediatr Surg Int"},{"key":"6445_CR17","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.1016\/j.jpedsurg.2020.11.005","volume":"56","author":"BJ Farr","year":"2021","unstructured":"Farr BJ, Carey DE, Mooney DP (2021) When to take it out? Optimal timing of interval appendectomy in 500 consecutive children. J Pediatr Surg 56:1822\u20131825. https:\/\/doi.org\/10.1016\/j.jpedsurg.2020.11.005","journal-title":"J Pediatr Surg"},{"key":"6445_CR18","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1007\/s00383-014-3521-y","volume":"30","author":"D Fawkner-Corbett","year":"2014","unstructured":"Fawkner-Corbett D, Jawaid WB, McPartland J, Losty PD (2014) Interval appendectomy in children clinical outcomes, financial costs and patient benefits. Pediatr Surg Int 30:743\u2013746. https:\/\/doi.org\/10.1007\/s00383-014-3521-y","journal-title":"Pediatr Surg Int"},{"key":"6445_CR19","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1007\/s00423-012-1042-5","volume":"398","author":"J Fawley","year":"2013","unstructured":"Fawley J, Gollin G (2013) Expanded utilization of nonoperative management for complicated appendicitis in children. Langenbecks Arch Surg 398:463\u2013466. https:\/\/doi.org\/10.1007\/s00423-012-1042-5","journal-title":"Langenbecks Arch Surg"},{"key":"6445_CR20","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1016\/j.jpedsurg.2019.05.001","volume":"55","author":"D Fouad","year":"2020","unstructured":"Fouad D, Kauffman JD, Chandler NM (2020) Pathology findings following interval appendectomy: Should it stay or go? J Pediatr Surg 55:737\u2013741. https:\/\/doi.org\/10.1016\/j.jpedsurg.2019.05.001","journal-title":"J Pediatr Surg"},{"key":"6445_CR21","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1007\/s12262-014-1121-7","volume":"77","author":"T Furuya","year":"2015","unstructured":"Furuya T, Inoue M, Sugito K et al (2015) Effectiveness of Interval Appendectomy After Conservative Treatment of Pediatric Ruptured Appendicitis with Abscess. Indian J Surg 77:1041\u20131044. https:\/\/doi.org\/10.1007\/s12262-014-1121-7","journal-title":"Indian J Surg"},{"key":"6445_CR22","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1016\/S0022-3468(00)90206-9","volume":"35","author":"DB Gahukamble","year":"2000","unstructured":"Gahukamble DB, Gahukamble LD (2000) Surgical and pathological basis for interval appendicectomy after resolution of appendicular mass in children. J Pediatr Surg 35:424\u2013427. https:\/\/doi.org\/10.1016\/S0022-3468(00)90206-9","journal-title":"J Pediatr Surg"},{"key":"6445_CR23","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1046\/j.0007-1323.2001.01912.x","volume":"88","author":"J Gillick","year":"2001","unstructured":"Gillick J, Velayudham M, Puri P (2001) Conservative management of appendix mass in children. J Br Surg 88:1539\u20131542. https:\/\/doi.org\/10.1046\/j.0007-1323.2001.01912.x","journal-title":"J Br Surg"},{"key":"6445_CR24","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1007\/s00383-007-2103-7","volume":"24","author":"J Gillick","year":"2008","unstructured":"Gillick J, Mohanan N, Das L, Puri P (2008) Laparoscopic appendectomy after conservative management of appendix mass. Pediatr Surg Int 24:299\u2013301. https:\/\/doi.org\/10.1007\/s00383-007-2103-7","journal-title":"Pediatr Surg Int"},{"key":"6445_CR25","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.jss.2012.03.009","volume":"177","author":"CW Iqbal","year":"2012","unstructured":"Iqbal CW, Knott EM, Mortellaro VE et al (2012) Interval appendectomy after perforated appendicitis: what are the operative risks and luminal patency rates? J Surg Res 177:127\u2013130. https:\/\/doi.org\/10.1016\/j.jss.2012.03.009","journal-title":"J Surg Res"},{"key":"6445_CR26","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1097\/SLE.0000000000000968","volume":"31","author":"E Kim","year":"2021","unstructured":"Kim E, Kim K, Park Y (2021) Benefits and reduced hospital costs of direct surgery in perforated appendicitis with abscess cost-effectiveness analysis of treatment complicated appendicitis. Surg Laparosc Endosc Percutan Tech 31:707\u2013710. https:\/\/doi.org\/10.1097\/SLE.0000000000000968","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"6445_CR27","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/s12893-016-0188-4","volume":"16","author":"C-C Luo","year":"2016","unstructured":"Luo C-C, Cheng K-F, Huang C-S et al (2016) Therapeutic effectiveness of percutaneous drainage and factors for performing an interval appendectomy in pediatric appendiceal abscess. BMC Surg 16:72. https:\/\/doi.org\/10.1186\/s12893-016-0188-4","journal-title":"BMC Surg"},{"key":"6445_CR28","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1089\/sur.2022.283","volume":"23","author":"P Luo","year":"2022","unstructured":"Luo P, Wang D, Kang Q (2022) Risk factors of recurrent appendiceal abscess after initial non-surgical treatment without drainage of children with appendiceal abscess: a single center retrospective review. Surg Infect (Larchmt) 23:887\u2013892. https:\/\/doi.org\/10.1089\/sur.2022.283","journal-title":"Surg Infect (Larchmt)"},{"key":"6445_CR29","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1089\/sur.2004.5.349","volume":"5","author":"EP Nadler","year":"2004","unstructured":"Nadler EP, Reblock KK, Vaughan KG et al (2004) Predictors of outcome for children with perforated appendicitis initially treated with non-operative management. Surg Infect (Larchmt) 5:349\u2013356. https:\/\/doi.org\/10.1089\/sur.2004.5.349","journal-title":"Surg Infect (Larchmt)"},{"key":"6445_CR30","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.1007\/s00595-014-0950-0","volume":"44","author":"S Otake","year":"2014","unstructured":"Otake S, Suzuki N, Takahashi A et al (2014) Histological analysis of appendices removed during interval appendectomy after conservative management of pediatric patients with acute appendicitis with an inflammatory mass or abscess. Surg Today 44:1400\u20131405. https:\/\/doi.org\/10.1007\/s00595-014-0950-0","journal-title":"Surg Today"},{"key":"6445_CR31","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1089\/lap.2006.16.308","volume":"16","author":"A Owen","year":"2006","unstructured":"Owen A, Moore O, Marven S, Roberts J (2006) Interval laparoscopic appendectomy in children. J Laparoendosc Adv Surg Tech 16:308\u2013311. https:\/\/doi.org\/10.1089\/lap.2006.16.308","journal-title":"J Laparoendosc Adv Surg Tech"},{"key":"6445_CR32","doi-asserted-by":"publisher","first-page":"811","DOI":"10.3390\/children8090811","volume":"8","author":"F Pederiva","year":"2021","unstructured":"Pederiva F, Bussani R, Shafiei V et al (2021) The histopathology of the appendix in children at interval appendectomy. Children 8:811. https:\/\/doi.org\/10.3390\/children8090811","journal-title":"Children"},{"key":"6445_CR33","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.1016\/j.jpedsurg.2007.04.011","volume":"42","author":"D Puapong","year":"2007","unstructured":"Puapong D, Lee SL, Haigh PI et al (2007) Routine interval appendectomy in children is not indicated. J Pediatr Surg 42:1500\u20131503. https:\/\/doi.org\/10.1016\/j.jpedsurg.2007.04.011","journal-title":"J Pediatr Surg"},{"key":"6445_CR34","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1016\/j.amjsurg.2007.08.021","volume":"194","author":"JP Roach","year":"2007","unstructured":"Roach JP, Partrick DA, Bruny JL et al (2007) Complicated appendicitis in children: a clear role for drainage and delayed appendectomy. Am J Surg 194:769\u2013773. https:\/\/doi.org\/10.1016\/j.amjsurg.2007.08.021","journal-title":"Am J Surg"},{"key":"6445_CR35","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1016\/j.jpedsurg.2017.09.012","volume":"53","author":"S Saluja","year":"2018","unstructured":"Saluja S, Sun T, Mao J et al (2018) Early versus late surgical management of complicated appendicitis in children: A statewide database analysis with one-year follow-up. J Pediatr Surg 53:1339\u20131344. https:\/\/doi.org\/10.1016\/j.jpedsurg.2017.09.012","journal-title":"J Pediatr Surg"},{"key":"6445_CR36","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1111\/ped.14358","volume":"63","author":"Y Takahashi","year":"2021","unstructured":"Takahashi Y, Obata S, Matsuura T et al (2021) The experiences of interval appendectomy for inflammatory appendiceal mass. Pediatr Int 63:88\u201393. https:\/\/doi.org\/10.1111\/ped.14358","journal-title":"Pediatr Int"},{"key":"6445_CR37","doi-asserted-by":"publisher","first-page":"1174","DOI":"10.1016\/j.jpedsurg.2016.01.006","volume":"51","author":"T Talishinskiy","year":"2016","unstructured":"Talishinskiy T, Limberg J, Ginsburg H et al (2016) Factors associated with failure of nonoperative treatment of complicated appendicitis in children. J Pediatr Surg 51:1174\u20131176. https:\/\/doi.org\/10.1016\/j.jpedsurg.2016.01.006","journal-title":"J Pediatr Surg"},{"key":"6445_CR38","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1007\/s00268-005-7946-2","volume":"30","author":"DW Vane","year":"2006","unstructured":"Vane DW, Fernandez N (2006) Role of Interval Appendectomy in the Management of Complicated Appendicitis in Children. World J Surg 30:51\u201354. https:\/\/doi.org\/10.1007\/s00268-005-7946-2","journal-title":"World J Surg"},{"key":"6445_CR39","doi-asserted-by":"publisher","first-page":"1970","DOI":"10.1016\/j.jpedsurg.2008.04.014","volume":"43","author":"C Whyte","year":"2008","unstructured":"Whyte C, Tran E, Lopez ME, Harris BH (2008) Outpatient interval appendectomy after perforated appendicitis. J Pediatr Surg 43:1970\u20131972. https:\/\/doi.org\/10.1016\/j.jpedsurg.2008.04.014","journal-title":"J Pediatr Surg"},{"key":"6445_CR40","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1007\/s00068-019-01277-0","volume":"47","author":"Y Zhang","year":"2021","unstructured":"Zhang Y, Deng Q, Zhu H et al (2021) Intermediate-term evaluation of interval appendectomy in the pediatric population. Eur J Trauma Emerg Surg 47:1041\u20131047. https:\/\/doi.org\/10.1007\/s00068-019-01277-0","journal-title":"Eur J Trauma Emerg Surg"},{"key":"6445_CR41","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1007\/s42804-023-00177-w","volume":"5","author":"F Ghidini","year":"2023","unstructured":"Ghidini F, Don\u00e0 D, Giacomini E et al (2023) Benefit for non-operative treatment of pediatric appendicitis with intra-abdominal abscess. A single-center report. J Pediatr Endoscopic Surg 5:73\u201378. https:\/\/doi.org\/10.1007\/s42804-023-00177-w","journal-title":"J Pediatr Endoscopic Surg"},{"key":"6445_CR42","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/j.pedneo.2019.01.005","volume":"60","author":"F Badru","year":"2019","unstructured":"Badru F, Piening N, Munoz Abraham AS et al (2019) Abscess and symptoms duration upon presentation should guide decision algorithms for early versus interval appendectomy in children. Pediatr Neonatol 60:530\u2013536. https:\/\/doi.org\/10.1016\/j.pedneo.2019.01.005","journal-title":"Pediatr Neonatol"},{"key":"6445_CR43","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1007\/s11605-013-2143-3","volume":"17","author":"H-L Zhang","year":"2013","unstructured":"Zhang H-L, Bai Y-Z, Zhou X, Wang W-L (2013) Nonoperative management of appendiceal phlegmon or abscess with an appendicolith in children. J Gastrointest Surg 17:766\u2013770. https:\/\/doi.org\/10.1007\/s11605-013-2143-3","journal-title":"J Gastrointest Surg"},{"key":"6445_CR44","doi-asserted-by":"publisher","first-page":"39","DOI":"10.4236\/SS.2011.22009","volume":"2","author":"IA James","year":"2011","unstructured":"James IA, Druhan S, Caniano DA et al (2011) The Presence but not the Location of an Appendicolith Affects the Success of Interval Appendectomy in Children with Ruptured Appendicitis. Surg Sci 2:39\u201344. https:\/\/doi.org\/10.4236\/SS.2011.22009","journal-title":"Surg Sci"},{"key":"6445_CR45","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1016\/j.jpedsurg.2007.01.024","volume":"42","author":"CJ Aprahamian","year":"2007","unstructured":"Aprahamian CJ, Barnhart DC, Bledsoe SE et al (2007) Failure in the nonoperative management of pediatric ruptured appendicitis: predictors and consequences. J Pediatr Surg 42:934\u2013938. https:\/\/doi.org\/10.1016\/j.jpedsurg.2007.01.024","journal-title":"J Pediatr Surg"},{"key":"6445_CR46","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1016\/j.jpedsurg.2009.10.039","volume":"45","author":"SD St. Peter","year":"2010","unstructured":"St. Peter SD, Aguayo P, Fraser JD et al (2010) Initial laparoscopic appendectomy versus initial nonoperative management and interval appendectomy for perforated appendicitis with abscess: a prospective, randomized trial. J Pediatr Surg 45:236\u2013240. https:\/\/doi.org\/10.1016\/j.jpedsurg.2009.10.039","journal-title":"J Pediatr Surg"},{"key":"6445_CR47","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1016\/S2468-1253(16)30243-6","volume":"2","author":"NJ Hall","year":"2017","unstructured":"Hall NJ, Eaton S, Stanton MP et al (2017) Active observation versus interval appendicectomy after successful non-operative treatment of an appendix mass in children (CHINA study): an open-label, randomised controlled trial. Lancet Gastroenterol Hepatol 2:253\u2013260. https:\/\/doi.org\/10.1016\/S2468-1253(16)30243-6","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"6445_CR48","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1001\/archsurg.2011.6","volume":"146","author":"ML Blakely","year":"2011","unstructured":"Blakely ML, Williams R, Dassinger MS et al (2011) Early vs interval appendectomy for children with perforated appendicitis. Arch Surg 146:660. https:\/\/doi.org\/10.1001\/archsurg.2011.6","journal-title":"Arch Surg"},{"key":"6445_CR49","doi-asserted-by":"publisher","first-page":"1809","DOI":"10.1016\/j.jpedsurg.2018.10.107","volume":"54","author":"A Munoz","year":"2019","unstructured":"Munoz A, Hazboun R, Vannix I et al (2019) Young children with perforated appendicitis benefit from prompt appendectomy. J Pediatr Surg 54:1809\u20131814. https:\/\/doi.org\/10.1016\/j.jpedsurg.2018.10.107","journal-title":"J Pediatr Surg"},{"key":"6445_CR50","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/j.jpedsurg.2013.10.001","volume":"49","author":"PP Nazarey","year":"2014","unstructured":"Nazarey PP, Stylianos S, Velis E et al (2014) Treatment of suspected acute perforated appendicitis with antibiotics and interval appendectomy. J Pediatr Surg 49:447\u2013450. https:\/\/doi.org\/10.1016\/j.jpedsurg.2013.10.001","journal-title":"J Pediatr Surg"},{"key":"6445_CR51","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1055\/s-0035-1551571","volume":"26","author":"B Parmentier","year":"2015","unstructured":"Parmentier B, Berrebi D, Peycelon M et al (2015) Failure of first-line antibiotics in nonoperative management of appendiceal mass, toward a second-line instead of surgery? Eur J Pediatr Surg 26:267\u2013272. https:\/\/doi.org\/10.1055\/s-0035-1551571","journal-title":"Eur J Pediatr Surg"},{"key":"6445_CR52","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1055\/s-0040-1715439","volume":"31","author":"C Pennell","year":"2021","unstructured":"Pennell C, Meckmongkol T, Prasad R et al (2021) A Standardized Protocol for Nonoperative Management of Complicated Appendicitis in Children Reduces Resource Utilization. Eur J Pediatr Surg 31:14\u201319. https:\/\/doi.org\/10.1055\/s-0040-1715439","journal-title":"Eur J Pediatr Surg"},{"key":"6445_CR53","doi-asserted-by":"publisher","first-page":"882","DOI":"10.1053\/jpsu.2002.32895","volume":"37","author":"M Samuel","year":"2002","unstructured":"Samuel M, Hosie G, Holmes K (2002) Prospective evaluation of nonsurgical versus surgical management of appendiceal mass. J Pediatr Surg 37:882\u2013886. https:\/\/doi.org\/10.1053\/jpsu.2002.32895","journal-title":"J Pediatr Surg"},{"key":"6445_CR54","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1007\/s00383-014-3484-z","volume":"30","author":"JF Svensson","year":"2014","unstructured":"Svensson JF, Johansson R, Kaiser S, Wester T (2014) Recurrence of acute appendicitis after non-operative treatment of appendiceal abscess in children: a single-centre experience. Pediatr Surg Int 30:413\u2013416. https:\/\/doi.org\/10.1007\/s00383-014-3484-z","journal-title":"Pediatr Surg Int"},{"key":"6445_CR55","doi-asserted-by":"publisher","first-page":"1957","DOI":"10.1016\/j.jpedsurg.2016.09.017","volume":"51","author":"Y Tanaka","year":"2016","unstructured":"Tanaka Y, Uchida H, Kawashima H et al (2016) More than one-third of successfully nonoperatively treated patients with complicated appendicitis experienced recurrent appendicitis: Is interval appendectomy necessary? J Pediatr Surg 51:1957\u20131961. https:\/\/doi.org\/10.1016\/j.jpedsurg.2016.09.017","journal-title":"J Pediatr Surg"},{"key":"6445_CR56","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1097\/XCS.0000000000001255","volume":"240","author":"ZJ Hellmann","year":"2025","unstructured":"Hellmann ZJ, Rehman S, Hornick M, Solomon DG (2025) Unplanned readmission rate before interval appendectomy after nonoperative management of complicated appendicitis. J Am Coll Surg 240:908\u2013913. https:\/\/doi.org\/10.1097\/XCS.0000000000001255","journal-title":"J Am Coll Surg"},{"key":"6445_CR57","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/j.jamcollsurg.2011.12.026","volume":"214","author":"AL Myers","year":"2012","unstructured":"Myers AL, Williams RF, Giles K et al (2012) Hospital cost analysis of a prospective, randomized trial of early vs interval appendectomy for perforated appendicitis in children. J Am Coll Surg 214:427\u2013434. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2011.12.026","journal-title":"J Am Coll Surg"},{"key":"6445_CR58","doi-asserted-by":"publisher","first-page":"1817","DOI":"10.1016\/j.jpedsurg.2010.03.016","volume":"45","author":"MV Raval","year":"2010","unstructured":"Raval MV, Lautz T, Reynolds M, Browne M (2010) Dollars and sense of interval appendectomy in children: A cost analysis. J Pediatr Surg 45:1817\u20131825. https:\/\/doi.org\/10.1016\/j.jpedsurg.2010.03.016","journal-title":"J Pediatr Surg"}],"container-title":["Pediatric Surgery International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-026-06445-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00383-026-06445-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-026-06445-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:47:54Z","timestamp":1781650074000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00383-026-06445-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,27]]},"references-count":58,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6445"],"URL":"https:\/\/doi.org\/10.1007\/s00383-026-06445-z","relation":{},"ISSN":["1437-9813"],"issn-type":[{"value":"1437-9813","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,27]]},"assertion":[{"value":"18 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"205"}}