Appendectomy Versus Observation for Appendicitis in Neutropenic Children With Cancer

BACKGROUND: Optimal management of neutropenic appendicitis (NA) in children undergoing cancer therapy remains undefined. Management strategies include upfront appendectomy or initial nonoperative management. We aimed to characterize the effect strategy on complications and length stay (LOS) describe implications for chemotherapy delay alteration. METHODS: Sites from Pediatric Surgery Oncology Research Collaborative performed a retrospective review with NA over 6-year period. RESULTS: Sixty-six children, median age 11 years (range 1–17), were identified while treatment. The most common diagnoses leukemia (62%) brain tumor (12%). Upfront was 41% patients; remainder had Rates abscess perforation at diagnosis equivalent groups (30% vs 24%; P = .23). Of patients who management, 46% (17 37) underwent delayed during same hospitalization. Delayed due failure 65% (n 11) count recovery 35% 6). Cancer 23). Initial associated treatment (46% vs. 22%, .05) longer LOS (29 12 days; .01). Patients higher rate postoperative (P CONCLUSIONS: In pediatric oncologic treatment, resulted lower complication rates, reduced LOS, fewer alterations regimens compared