Safety and Efficacy of Endoscopic Retrograde Appendicitis Therapy for pediatric patients: A Single-Center Retrospective Study in Chinese Children

Objectives: Endoscopic retrograde appendicitis therapy (ERAT) is a new and non-invasive endoscopic technique originally developed by Liu in China for the management of acute appendicitis. While its safety and efficacy have been extensively validated in adult populations, evidence regarding its use in pediatric patients remains scarce. The aim of this study was to evaluate the clinical outcomes of ERAT in pediatric appendicitis. Methods: This retrospective study analyzed pediatric patients who underwent ERAT in our hospital between January 2019 and August 2022. Data collected included patient demographics, the success rate of ERAT, and the duration of hospital stay. Additionally, recurrence rates were assessed during the follow-up to evaluate the safety and long-term efficacy of the procedure. Results: A total of 73 patients were included in this study. Appendiceal intubation was successfully performed in 72/73 patients (98.63%). Among these patients, 72.22% of patients had appendiceal fecal stones or food residue, and the success rate of stone removal was 94.23%. Overall, clinical success rate of the procedure was 91.78%. The median procedure time was 22 minutes (IQR 15-36.5), and median postoperative hospital stay was 2 days (IQR 1-4). During the 1-year follow-up, 14.92% of the patients had recurrence appendicitis. Conclusions: ERAT appears to be a safe and effective alternative approach to treat appendicitis in pediatric patients, especially for obstructive appendicitis with appendicolith.