ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Surgery
Early versus Interval Appendectomy in Children with Complicated Appendicitis: Effects on Hospital Stay and Occurrence of Severe Complications
Yannick Schmidt
Franziska Cramer
Oliver Muensterer
Danielle S Wendling-Keim
Ludwig Maximilian University of Munich, Munich, Germany
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Abstract
Abstract Purpose: Acute appendicitis is a common pediatric emergency, yet optimal management of complicated cases remains debated. This study compares outcomes of early versus interval appendectomy in children with perforated appendicitis. Methods: A retrospective review of 254 patients (<18 years) treated between January 2012 and December 2023 was conducted. Twenty-two underwent interval appendectomy, and 232 underwent early appendectomy. Demographic and clinical data were analyzed using SPSS v29.0.1.0, with statistical significance defined as p<0.05. Results: Early appendectomy was associated with a significantly shorter cumulative hospital stay (mean 9.2 days) than interval appendectomy (mean 22.5 days; p<0.001). Overall complication rates were higher in the interval group (10/22) compared to the early group (31/232; p<0.001). However, severe complications, such as ileostomy creation, stump insufficiency, and ileocecal pole resection, occurred exclusively in the early appendectomy group. Conclusion: Early appendectomy in children with complicated appendicitis results in shorter hospitalization and fewer overall complications but carries a risk of more severe postoperative events. Prospective studies are warranted to refine patient selection and optimize treatment strategies.
Summary
Keywords
Complicated appendicitis, Early appendectomy, Hospital stay, Interval appendectomy, Pediatric Surgery, Postoperative Complications
Received
15 January 2026
Accepted
20 February 2026
Copyright
© 2026 Schmidt, Cramer, Muensterer and Wendling-Keim. 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: Danielle S Wendling-Keim
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