Call to limit appendix ops for children

OPERATING on children with acute appendicitis may be unnecessary in many cases, a British study suggests.

Removal has been the standard treatment for the illness for more than a century. But doctors at Southampton Children’s Hospital have now found simply treating the problem with antibiotics can be just as effective.

They found that among children with a common acute form of the illness – appendix mass – three quarters could be safely treated without surgery.

Avoiding an operation would mean children could avoid a general anaesthetic and the pain of surgery and might not even need an overnight stay in hospital. Although removal is relatively straightforward any invasive procedure carries risks.

Most doctors treat appendix mass with antibiotics, but then remove the organ – ‘interval appendicectomy’ – to stop infection returning.

But the researchers, writing in the Lancet Gastroenterology and Hepatology journal, said this ‘surgical dogma’ should change.

Nigel Hall, a consultant paediatric surgeon who led the study, said: ‘Up until now more than two thirds of surgeons were routinely recommending interval appendicectomy. Yet the justification for this surgical intervention has never been challenged.’

The team studied 102 children at 17 hospitals in the UK, along with one in Sweden and one in New Zealand. One in 12 people develop appendicitis at some point.