Early Versus Delayed Operation for Perforated Appendicitis

Not Applicable

Completed

• Conditions: Appendiceal Abscess
• Interventions: Procedure: Drainage and Interval Appendectomy; Procedure: Operation on Admission

• Registration Number: NCT00414375
• Lead Sponsor: Children's Mercy Hospital Kansas City

Brief Summary

The objective of this study is to scientifically evaluate two different operative strategies for perforated appendicitis with abscess.

The hypothesis is that the increased difficulty of early operation is balanced by the immense patient investment with delayed operation.

Detailed Description

This will be a single institution, prospective, randomized clinical trial involving patients who present to the hospital with perforated appendicitis with abscess. This will be a pilot study.

Power calculations are not used for a pilot study. One group will undergo a primary laparoscopic appendectomy. The other group will receive intravenous antibiotics with drainage if possible and a laparoscopic appendectomy 10 weeks after initiation of treatment at presentation. All 7 general pediatric surgeons will be involved with the operations, who are all comfortable with these management arms. The surgeon will not induce a significant confounding variable into this study. The laparoscopic appendectomy is approached in the same manner by all members of our group. Those named on the form are qualified by the IRB to obtain consent and/or will be accountable for overseeing the study.

Both groups will have the same antibiotic regiment. All data will be analyzed on intention-to-treat basis.

Study Timeline

• Study Start: 2006-12
• Study First Submitted: 2006-12-19
• Study First Submitted QC: 2006-12-20
• Study First Posted: 2006-12-21
• Primary Completion: 2009-02
• Status Verified: 2009-03
• Study Completion: 2009-03
• Last Update Submitted: 2009-03-02
• Last Update Posted: 2009-03-03

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• Patients with perforated appendicitis and an abdominal abscess diagnosed on CT scan.
• Children of any age will be included.

Exclusion Criteria

• Patients with immune deficiency
• Another condition affecting surgical decision making or recovery (e.g. hemophilia, severe cardiac or respiratory co-morbidities).
• Acute sepsis or severe pain from perforation not allowing for delayed management.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
1	Drainage and Interval Appendectomy	Drainage with interval appendectomy
2	Operation on Admission	appendectomy on presentation

Primary Outcome Measures

Name	Time	Method
Pilot	3 months

Secondary Outcome Measures

Name	Time	Method
PIP and PedsQL4 scores, time to full feeds, days of hospitalization, recurrent abscess, number of recurrences, number of CT scans, operating time	3 months

Trial Locations

Locations (1)

Children's Mercy Hospital; 🇺🇸 Kansas City, Missouri, United States