Long-term outcomes of non-operative compared to operative management of acute uncomplicated appendicitis - a systematic review and meta-analysis.
Am J SurgAug 18, 2026 (epub)
Clinical ResearchGeneral Surgery
Noam Kahana, Elad Boaz, Sameh Hany Emile et al.
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In 30 seconds
This systematic review and meta-analysis evaluated long-term outcomes of non-operative management (NOM) versus surgical management for acute uncomplicated appendicitis in 3883 patients. The study found that the pooled long-term failure rate for NOM was 38.9%, increasing to 44.4% in randomized controlled trials. The median follow-up duration was 33.6 months.
Key findings
- Pooled long-term failure rate for NOM was 38.9% (95% CI: 31.1%-46.7%).
- In RCTs, the long-term failure rate for NOM increased to 44.4% (95% CI: 41.4%-47.4%).
- Pooled appendectomy rate after NOM was 36.3% (95% CI: 28.9%-43.7%).
- Non-operative management had cost savings of €1535 (95% CI: -€1892 to -€1178) compared to surgery.
Why it matters
Understanding the long-term outcomes of NOM versus surgery for appendicitis is crucial for clinicians in making informed treatment decisions, particularly given the high failure rates associated with NOM.