Children with severe constipation and a neurodiverse disorder (Autism and/or developmental delay) represent a challenging bowel management group. Treatment outcomes with laxative or enema therapy remain limited and are often complicated by patient/caregiver compliance. We hypothesized that children with neurodiverse disorders and severe constipation would benefit from a bowel management program (BMP) that includes early use of antegrade enemas.

We read the article by Neogi et al. [1] with great interest about “Laparoscopic versus open appendicectomy for complicated appendicitis in children: A systematic review and meta-analysis.” (doi: 10.1016/j.jpedsurg.2021.07.005.). The research included four randomized controlled trials (266 LA versus 354 OA) and thirty-six case-controlled trials (2580 LA versus 3043 OA). After analyzing, they concluded that laparoscopy has a better overall complication profile compared to OA and should be the procedure of choice in children with complicated appendicitis.