Skip to main content
SpringerLink
Log in

The feasibility of short-stay laparoscopic appendectomy for acute appendicitis: a prospective cohort study

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Short-stay laparoscopic appendectomy for acute appendicitis (AA) has not yet been validated. This study was designed to prospectively evaluate the hospital length of stay (LOS) after laparoscopic appendectomy for AA and to determine predictive factors for successful short-stay surgery (LOS <24 h).

Methods

Between January and December 2010, all consecutive adults admitted for AA were prospectively treated with LOS <24 h as a patient management goal. The proportion of patients with LOS <24 h was analyzed for the intention-to-treat (ITT) population and for the population eligible for short-stay surgery. Predictive factors for LOS <24 h were analyzed.

Results

Of the 123 patients included in this study, 71.5 % (88/123) were eligible for short-stay surgery. The proportion of LOS <24 h cases was 52 % (64/123) in the ITT population and 72.7 % (64/88) in the eligible population. LOS <12 h was achieved in 17.8 % (22/123) in the ITT patients and 25 % (22/88) of the eligible patients. The main cause of unexpected readmission was postoperative pain (n = 10, 8.1 %). Age <23 years and a serum C-reactive protein level <18 mg/l had a positive predictive value of 100 % for LOS <24 h. Of the eligible patients, 27.2 % (24/88) were subject to unplanned overnight admissions and postsurgery readmissions.

Conclusions

LOS <24 h was feasible for 52 % of patients admitted for AA and for 72.7 % of the patients eligible for short-term surgery. Low age and a low preoperative serum CRP level are predictive factors for the feasibility of short-stay laparoscopic appendectomy for AA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Flamant Y, Zantain OL, Barge J (1992) Questionable appendicectomies. Rev Prat 42:697–700

    PubMed  CAS  Google Scholar 

  2. Regimbeau JM, Panis Y, Le P, Soyer P, Kardache M, Rymer R, Valleur P (2003) Should routine spiral computed tomography be performed in adult patients with acute abdominal pain of the right lower quadrant? Int J Colorectal Dis 18:126–130

    PubMed  CAS  Google Scholar 

  3. Fingerhut A, Millat B, Borrie F (1999) Laparoscopic versus open appendectomy: time to decide. World J Surg 23:835–845

    Article  PubMed  CAS  Google Scholar 

  4. Bouillot JL, Bresler L (2004) Abdomens aigus: prise en charge diagnostique. Rapport du 106° Congrès de l’AFC, Arnette

  5. Lemos P, Jarrett P, Philip B (2006) Day surgery: development and practice. The International Association for Ambulatory Surgery (IAAS), London

    Google Scholar 

  6. Kraft K, Mariette C, Sauvanet A, Balon JM, Douard R, Fabre S, Guidat A, Huten N, Johanet H, Laurent A, Muscari F, Pessaux P, Piermé JP, Piessen G, Raucoules-Aimé M, Rault A, Vons C; French Society of Gastrointestinal Surgery, Association for Hepatobiliary, Transplantation Surgery (2011) Indications for ambulatory gastrointestinal and endocrine surgery in adults. J Visc Surg 148:69–74

    Google Scholar 

  7. Horn AE, Ufberg JW (2011) Appendicitis, diverticulitis, and colitis. Emerg Med Clin North Am 29:347–368

    Article  PubMed  Google Scholar 

  8. Gilliam AD, Anand R, Horgan LF, Attwood SE (2008) Day case emergency laparoscopic appendectomy. Surg Endosc 22:483–486

    Article  PubMed  CAS  Google Scholar 

  9. Alvarez C, Voitk AJ (2000) The road to ambulatory laparoscopic management of perforated appendicitis. Am J Surg 179:63–66

    Article  PubMed  CAS  Google Scholar 

  10. Brosseuk DT, Bathe OF (1999) Day-case laparoscopic appendectomies. Can J Surg 42:138–142

    PubMed  CAS  Google Scholar 

  11. Schreiber JH (1994) Results of outpatient laparoscopic appendectomy in women. Endoscopy 26:292–298

    Article  PubMed  CAS  Google Scholar 

  12. Jain A, Mercado PD, Grafton KP, Dorazio RA (1995) Outpatient laparoscopic appendectomy. Surg Endosc 9:424–425

    Article  PubMed  CAS  Google Scholar 

  13. Lord RV, Sloane DR (1996) Early discharge after open appendectomy. Aust N Z J Surg 66:361–365

    Article  PubMed  CAS  Google Scholar 

  14. Salam IM, Fallouji MA, el Ashaal YI, Chandran VP, Asham NN, Galala KH, Sim AJ (1995) Early patient discharge following appendectomy: safety and feasibility. J R Coll Surg Edinb 40:300–302

    PubMed  CAS  Google Scholar 

  15. Ramesh S, Galland RB (1993) Early discharge from hospital after open appendectomy. Br J Surg 80:1192–1193

    Article  PubMed  CAS  Google Scholar 

  16. Velhote CE, de Oliveira Velhote TF, Velhote MC, Moura DC (1999) Early discharge after appendectomy in children. Eur J Surg 165:465–467

    Article  PubMed  CAS  Google Scholar 

  17. Dubois L, Vogt KN, Davies W, Schlachta CM (2010) Impact of an outpatient appendectomy on clinical outcomes and cost: a case-control study. J Am Coll Surg 211:731–737

    Article  PubMed  Google Scholar 

  18. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  Google Scholar 

  19. Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG (1992) CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 13:606–608

    Article  PubMed  CAS  Google Scholar 

  20. Mutter D, Panis Y, Escat J (1999) Drainage in digestive surgery. French Society of Digestive Surgery. J Chir (Paris) 136:117–123

    CAS  Google Scholar 

  21. Société Française d'Anesthésie Réanimation (1993) Consensus conference of the French Society of Anesthesia and Intensive Care (11–12 December 1992). Ann Fr Anesth Reanim 12:337–354

    Google Scholar 

  22. Brehant O, Lehert P, Sabbagh C, Dhahri A, Fuks D, Regimbeau JM (2010) Prospective database of surgical site infections: does NNIS index always pertinent? J Visc Surg 147:30

    Google Scholar 

  23. Slim K, Bousquet J, Kwiatkowski F, Lescure G, Pezet D, Chipponi J (1999) First validation of the French version of the Gastrointestinal Quality of Life Index (GIQLI). Gastroenterol Clin Biol 23:25–31

    PubMed  CAS  Google Scholar 

  24. French National Authority for Health, French Association of Ambulatory Surgery (2010) Ambulatory surgery symposium: What project for surgery in France? Paris

  25. Statistical data. http://stats.atih.sante.fr/

  26. Mariette C, Boutillier J, Arnaud N, Piessen G, Ruolt N, Triboulet JP (2011) Outcome of day-case laparoscopic fundoplication for gastro-esophageal reflux disease. J Visc Surg 148:50–53

    Article  PubMed  CAS  Google Scholar 

  27. Johanet H, Marichez P, Gaux F (1996) Organization and results of the treatment of inguinal hernia by laparoscopy in ambulatory surgery. Immediate results. Ann Chir 50:814–819

    PubMed  CAS  Google Scholar 

  28. Ingraham AM, Cohen ME, Bilimoria KY, Ko CY, Hall BL, Russell TR, Nathens AB (2010) Effect of delay to operation on outcomes in adults with acute appendicitis. Arch Surg 145:886–892

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

None of the authors have any conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Digestive and Metabolic Surgery, Amiens University Hospital, Place Victor Pauchet, 80054, Amiens Cedex 01, France

    Charles Sabbagh, Olivier Brehant, François Browet, Aurélien Pequignot & Jean Marc Regimbeau

  2. Department of Anesthesiology and Critical Care Medicine, Amiens University Medical Center, Amiens, France

    Hervé Dupont

Authors
  1. Charles Sabbagh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Olivier Brehant
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hervé Dupont
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. François Browet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Aurélien Pequignot
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jean Marc Regimbeau
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean Marc Regimbeau.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sabbagh, C., Brehant, O., Dupont, H. et al. The feasibility of short-stay laparoscopic appendectomy for acute appendicitis: a prospective cohort study. Surg Endosc 26, 2630–2638 (2012). https://doi.org/10.1007/s00464-012-2244-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-012-2244-1

Keyword

Search

Navigation