{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T08:13:02Z","timestamp":1783930382381,"version":"3.55.0"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":193,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to validate our therapeutic strategy for the nonselective conservative treatment of pediatric acute appendicitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single\u2010center retrospective comparative study was conducted using the data of 368 patients with acute appendicitis. Two therapeutic strategies were compared: emergent open appendectomy (early group,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009138 patients; 2007\u20132011) and conservative antibiotic treatment (late group,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009230; 2012\u20132023). Both strategies were nonselectively applied, regardless of the degree of disease progression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      None of the patients in the late group required admission to the intensive care unit or experienced mortality. Compared with the early group, the late group had a significantly longer duration of hospitalization (5 vs. 7\u2009days;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0017) and a higher rate of non\u2010planned readmission after initial admission (2% vs. 13%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0004). Surgery was performed on a nonworking day for 26% of patients and at night for 59% of patients in the early group. However, subsequent interval appendectomy for patients in the late group was not performed on a nonworking day or at night.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nonselective conservative treatment with antibiotics was safe for managing acute appendicitis in children and eliminated the need for surgery at night and during nonworking days, despite longer duration of the initial hospitalization and the higher rate of readmission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70477","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T07:59:52Z","timestamp":1783929592000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of Nonselective Conservative Treatment for Pediatric Acute Appendicitis"],"prefix":"10.1111","volume":"68","author":[{"given":"Yuki","family":"Tsuji","sequence":"first","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery Jichi Medical University  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiko","family":"Usui","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery Jichi Medical University  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhisa","family":"Baba","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery Jichi Medical University  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachi","family":"Sekine","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery Jichi Medical University  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Terui","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery Jichi Medical University  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1053\/jpsu.2003.50052","article-title":"Appendicitis in Children: A Ten\u2010Year Update of Therapeutic Recommendations","volume":"38","author":"Emil S.","year":"2003","journal-title":"Journal of Pediatric Surgery"},{"key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1002\/bjs.1800820207","article-title":"Randomized Controlled Trial of Appendicectomy Versus Antibiotic Therapy for Acute Appendicitis","volume":"82","author":"Eriksson S.","year":"1995","journal-title":"British Journal of Surgery"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo\u20102017\u2010000028"},{"key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s13017-023-00531-6","article-title":"A Meta\u2010Analysis and Trial Sequential Analysis Comparing Nonoperative Versus Operative Management for Uncomplicated Appendicitis: A Focus on Randomized Controlled Trials","volume":"19","author":"Brucchi F.","year":"2024","journal-title":"World Journal of Emergency Surgery"},{"key":"e_1_2_13_6_1","article-title":"Conservative Versus Surgical Management of Acute Appendicitis: A Systematic Review","volume":"16","author":"Chin X.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1002\/ags3.12277","article-title":"Clinical Outcomes of Single\u2010Site Laparoscopic Interval Appendectomy for Severe Complicated Appendicitis: Comparison to Conventional Emergency Appendectomy","volume":"3","author":"Miyo M.","year":"2019","journal-title":"Annals of Gastroenterological Surgery"},{"key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1007\/s13304-023-01679-1","article-title":"Interval Appendectomy as a Safe and Feasible Treatment Approach After Conservative Treatment for Appendicitis With Abscess: A Retrospective, Single\u2010Center Cohort Study","volume":"75","author":"Suzuki T.","year":"2023","journal-title":"Updates in Surgery"},{"key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1053\/jpsu.2002.32893","article-title":"Pediatric Appendicitis Score","volume":"37","author":"Samuel M.","year":"2002","journal-title":"Journal of Pediatric Surgery"},{"key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.jpedsurg.2022.12.009","article-title":"Nationwide Management of Perforated Pediatric Appendicitis: Interval Versus Same\u2010Admission Appendectomy","volume":"58","author":"Huerta C. T.","year":"2023","journal-title":"Journal of Pediatric Surgery"},{"key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1055\/s-0040-1718406","article-title":"Predictive Value of Alvarado Score and Pediatric Appendicitis Score in the Success of Nonoperative Management for Simple Acute Appendicitis in Children","volume":"31","author":"Fuhrer A. E.","year":"2021","journal-title":"European Journal of Pediatric Surgery"},{"key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"3942","DOI":"10.3748\/wjg.v19.i25.3942","article-title":"Treatment Options of Inflammatory Appendiceal Masses in Adults","volume":"19","author":"Tannoury J.","year":"2013","journal-title":"World Journal of Gastroenterology"},{"key":"e_1_2_13_13_1","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S1091-255X(00)80062-1","article-title":"Internal Appendectomy in the Leparoscopic Era","volume":"4","author":"Befeler D.","year":"2000","journal-title":"Journal of Gastrointestinal Surgery"},{"key":"e_1_2_13_14_1","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/j.amjsurg.2017.07.039","article-title":"Operative Versus Non\u2010Operative Management in the Care of Patients With Complicated Appendicitis","volume":"214","author":"Helling T. S.","year":"2017","journal-title":"American Journal of Surgery"},{"key":"e_1_2_13_15_1","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1007\/s00384-019-03238-w","article-title":"Comparison of Conservative Versus Surgical Therapy for Acute Appendicitis With Abscess in Five German Hospitals","volume":"34","author":"Shekarriz S.","year":"2019","journal-title":"International Journal of Colorectal Disease"},{"key":"e_1_2_13_16_1","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-3003","article-title":"Efficacy and Safety of Nonoperative Treatment for Acute Appendicitis: A Meta\u2010Analysis","volume":"139","author":"Georgiou R.","year":"2017","journal-title":"Pediatrics"},{"key":"e_1_2_13_17_1","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1016\/j.surg.2022.04.021","article-title":"Defining the Optimal Time to Appendectomy: A Step Toward Precision Surgery","volume":"172","author":"Kabir T.","year":"2022","journal-title":"Surgery"},{"key":"e_1_2_13_18_1","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1097\/SLA.0000000000000492","article-title":"Safety of Short, In\u2010Hospital Delays Before Surgery for Acute Appendicitis: Multicentre Cohort Study, Systematic Review, and Meta\u2010Analysis","volume":"259","author":"United Kingdom National Surgical Research Collaborative","year":"2014","journal-title":"Annals of Surgery"},{"key":"e_1_2_13_19_1","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/S1470-2045(20)30675-6","article-title":"Global Demand for Cancer Surgery and an Estimate of the Optimal Surgical and Anaesthesia Workforce Between 2018 and 2040: A Population\u2010Based Modelling Study","volume":"22","author":"Perera S. K.","year":"2021","journal-title":"Lancet Oncology"},{"key":"e_1_2_13_20_1","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.jpedsurg.2017.01.050","article-title":"Cost Analysis of Nonoperative Management of Acute Appendicitis in Children","volume":"52","author":"Mudri M.","year":"2017","journal-title":"Journal of Pediatric Surgery"},{"key":"e_1_2_13_21_1","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.bja.2020.01.019","article-title":"Association Between Night\/After\u2010Hours Surgery and Mortality: A Systematic Review and Meta\u2010Analysis","volume":"124","author":"Cortegiani A.","year":"2020","journal-title":"British Journal of Anaesthesia"},{"key":"e_1_2_13_22_1","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/EJA.0000000000001930","article-title":"Peri\u2010Operative Night\u2010Time Work of Anaesthesiologists: A Qualitative Study of Critical Issues and Proposals","volume":"41","author":"Ippolito M.","year":"2024","journal-title":"European Journal of Anaesthesiology"}],"container-title":["Pediatrics International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70477","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ped.70477","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T07:59:54Z","timestamp":1783929594000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ped.70477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ped.70477"],"URL":"https:\/\/doi.org\/10.1111\/ped.70477","archive":["Portico"],"relation":{},"ISSN":["1328-8067","1442-200X"],"issn-type":[{"value":"1328-8067","type":"print"},{"value":"1442-200X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-01-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70477"}}