Modified endoscopic retrograde appendicitis therapy vs. laparoscopic appendectomy for uncomplicated acute appendicitis in children

Modified endoscopic retrograde appendicitis therapy (mERAT) has been proposed as an alternative to laparoscopic appendectomy for the treatment of appendicitis. However, data from children in large samples are lacking. The aim of this article is to evaluate the efficacy between mERAT and laparoscopic appendectomy (LA) in children with uncomplicated appendicitis METHOD: We retrospectively analyzed 594 patients with suspected AUA from October 2018 to May 2021. A pool of 294 consecutive patients who met the inclusion criteria were ultimately enrolled in this study (228 and 66 patients in mERAT and LA, respectively). Given the differences in baseline clinical data (gender, age), the regression equation including difference clinical baseline, grouping factor, and white blood cell (WBC) count was established to address the influence of potential confounding factors.The initial success rate of mERAT management was 96.9%, and the recurrence rate was 6.9% in mERAT and 1.7% in LA group within one year, which was no significant difference. But mERAT group has lower adverse events rate. Finally, those results indicated that the treatment modalities, LA or mERAT, had no significant effect on initial success rate (P=0.99), and recurrence rate (P=0.17) within 1 year but significant effect on the adverse events rate during hospitalization (P=0.01) in the multivariate regression analysis.Among children with uncomplicated appendicitis, an initial mERAT management strategy had a success rate of 96.9% which was similar to LA group at 1 year. This follow-up supports the feasibility of mERAT alone as an alternative to surgery for AUA.