Early versus interval appendectomy in children with complicated appendicitis: effects on hospital stay and occurrence of severe complications

Purpose Acute appendicitis is a common pediatric emergency, yet optimal management of complicated cases remains debated. This study compares outcomes of early vs. 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.