CLINICAL TRIAL article
Front. Pediatr.
Sec. Pediatric Surgery
Volume 13 - 2025 | doi: 10.3389/fped.2025.1579645
The effect of osteopathic manipulative treatment on lenght of stay and pain relief in pediatric appendectomy: a pilot non-randomized timecontrolled clinical trial
Provisionally accepted
Michele Maria Cantagalli1*
Roberto Lo Piccolo1,2*
Tommaso Ferroni3
Antonino Morabito1,2Florinda Fracchiolla3- 1University of Florence, Florence, Italy
- 2Department of Pediatric Surgery, Meyer Children's Hospital, Florence, Italy
- 3Osteopathy, Meyer Children's Hospital IRCCS, Florence, Italy
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction: Appendicitis is the most frequent non-traumatic surgical emergency in children. While laparoscopic surgery is standard, postoperative recovery often involves pain, delayed bowel function, and reduced mobility. Osteopathic manipulative treatment (OMT) may improve recovery by addressing fascial restrictions and visceral dysfunction. This pilot study investigates OMT’s effect on postoperative pain and hospital length of stay in pediatric patients undergoing appendectomy.Methods: This non-randomized, time-controlled clinical trial was conducted at Meyer Pediatric Hospital (Florence, Italy) with 43 patients aged 5–17 undergoing laparoscopic appendectomy. Participants were divided by appendicitis type (complicated/uncomplicated) and treatment group (OMT vs. control). The OMT group received two standardized sessions within 48 hours post-surgery. Primary outcomes included postoperative pain (assessed via Numeric Rating Scale) and hospital stay. Secondary outcomes included bowel function, mobilization, and nausea/vomiting. Data were analyzed using multivariate statistics and t-tests, with p < 0.05 as the significance threshold.Results: The OMT group showed a shorter mean hospital stay (4.6 vs. 7 days) and significantly greater reductions in abdominal and shoulder pain compared to controls. In uncomplicated appendicitis, pain reduction reached 3/10 vs. 1.7/10 in controls; in complicated cases, 3.6/10 vs. 1.8/10. Shoulder pain relief was also more pronounced in the OMT groups. Improvements in bowel function, mobilization, and nausea were observed in both groups, with no statistically significant differences.Conclusions: This pilot study provides preliminary evidence that OMT may enhance postoperative recovery in pediatric appendectomy by reducing pain and potentially shortening hospital stays. Although not statistically significant due to the small sample size, the clinical relevance of these findings supports further investigation through larger, randomized trials.
Keywords: Pediatric Surgery, Osteopathic treatment of children, Fast recovery, Pain Management, Appendicectomy
Received: 19 Feb 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 Cantagalli, Lo Piccolo, Ferroni, Morabito and Fracchiolla. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Michele Maria Cantagalli, University of Florence, Florence, Italy
Roberto Lo Piccolo, University of Florence, Florence, Italy
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.