Early versus delayed laparoscopic appendectomy for acute uncomplicated appendicitis in adults: a systematic review and meta-analysis
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.027 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.036 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".