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Background <p>The optimal timing of laparoscopic appendectomy for acute uncomplicated appendicitis remains uncertain. We performed a systematic review and meta-analysis to compare operative and safety outcomes following early versus delayed laparoscopic appendectomy in adults.</p> Methods <p>PubMed, Cochrane Central, and ClinicalTrials.gov were searched through October 2024 for randomized and cohort studies. Six studies (one RCT, five cohorts) including 2,429 patients were analyzed. Risk of bias was evaluated using the Newcastle-Ottawa Scale and Cochrane tools. Meta-analysis was conducted using RevMan and R (meta/metafor).</p> Results <p>There were no significant differences in operative time (mean difference − 2.3&#xa0;min) or postoperative length of stay (− 0.7 days). Rates of perforation (RR 0.87), mortality (RR 0.87), surgical-site infection (RR 0.98), overall complications (RR 0.94), and 30-day readmission (RR 1.16) were comparable between groups. Cohort studies were of high quality, while the single RCT showed minor bias concerns.</p> Conclusions <p>Our Systematic Review and Meta-Analysis produced comparable operative and safety outcomes between early and delayed appendectomy, indicating that a delay in operation of 8&#xa0;h, due to logistics issues, can be acceptable in terms of clinical outcomes. This recommendation can be solidified via further randomized controlled trials and larger umbrella reviews.</p>

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Early versus delayed laparoscopic appendectomy for acute uncomplicated appendicitis in adults: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月13日

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  • Iftikhar Khan,
  • Soban Ali Qasim,
  • Haris Mumtaz Malik,
  • Muhammad Hamza,
  • Umna Bhatti,
  • FNU Sawaira,
  • Syeda Wania Haider,
  • Saad Khan,
  • Ehsanullah Alokozay,
  • Muhammad Abdullah Ali,
  • Fariha Hasan,
  • Muhammad Riyyan

摘要

Background

The optimal timing of laparoscopic appendectomy for acute uncomplicated appendicitis remains uncertain. We performed a systematic review and meta-analysis to compare operative and safety outcomes following early versus delayed laparoscopic appendectomy in adults.

Methods

PubMed, Cochrane Central, and ClinicalTrials.gov were searched through October 2024 for randomized and cohort studies. Six studies (one RCT, five cohorts) including 2,429 patients were analyzed. Risk of bias was evaluated using the Newcastle-Ottawa Scale and Cochrane tools. Meta-analysis was conducted using RevMan and R (meta/metafor).

Results

There were no significant differences in operative time (mean difference − 2.3 min) or postoperative length of stay (− 0.7 days). Rates of perforation (RR 0.87), mortality (RR 0.87), surgical-site infection (RR 0.98), overall complications (RR 0.94), and 30-day readmission (RR 1.16) were comparable between groups. Cohort studies were of high quality, while the single RCT showed minor bias concerns.

Conclusions

Our Systematic Review and Meta-Analysis produced comparable operative and safety outcomes between early and delayed appendectomy, indicating that a delay in operation of 8 h, due to logistics issues, can be acceptable in terms of clinical outcomes. This recommendation can be solidified via further randomized controlled trials and larger umbrella reviews.