Return to Sports and Physical Activity After Appendectomy in Children: A Review

Abstract

Background. Appendectomy is one of the most frequently performed emergency surgical procedures in children, yet recommendations regarding the timing of return to physical activity remain highly variable and are often based on expert opinion rather than robust evidence.
Aim. To review the available evidence on return to physical activity after pediatric appendectomy and propose a practical, criteria-based framework for safe postoperative activity progression.
Material and methods. A review of the literature was conducted, focusing on studies evaluating postoperative activity restrictions, return to sport, abdominal wall healing, and recovery following pediatric appendectomy. Evidence from pediatric and broader abdominal surgery literature was analyzed.
Results. Current pediatric evidence is limited and demonstrates considerable variability in postoperative recommendations. Available studies suggest that, after uncomplicated laparoscopic appendectomy, self-directed return to activity as tolerated does not increase postoperative complications and may accelerate recovery. Prolonged routine activity restriction has not been shown to reduce the risk of fascial dehiscence or incisional hernia. Recovery should instead be individualized according to surgical approach, disease severity, wound healing, pain, functional recovery, and postoperative complications. Emerging wearable-device metrics may provide objective recovery assessment in the future but are not yet suitable for routine clinical decision-making.
Conclusions. Children undergoing uncomplicated laparoscopic appendectomy can generally resume daily activities and gradually return to sports using symptom- and function-based criteria rather than fixed time intervals. More cautious progression is warranted after complicated appendicitis or open surgery. High-quality prospective studies are needed to establish standardized, evidence-based recommendations.