BAPS paperA prospective study of safety and satisfaction with same-day discharge after laparoscopic appendectomy for acute appendicitis
Section snippets
Methods
Our institutional review board approved the study of same-day discharge after appendectomy for acute appendicitis. During the research period (July 2010-December 2010), all patients presenting with the preoperative diagnosis of acute appendicitis were placed on the outpatient appendectomy protocol. The surgical team counseled the parents before surgery that same-day discharge was expected and described the benefits of that plan of action. Patients found at operation to have perforated or
Results
Over the 6-month period, surgeons took 179 children to the operating room for presumed simple acute appendicitis at Miami Children's Hospital. Gangrene or perforation was noted in 21 children, and these were admitted for antibiotics postoperatively and excluded from further study. Laparoscopic appendectomy was performed in the remaining 158 children with a mean age of 12 (2-19) years (Table 2). Single-port, “all-in-one” appendectomy was possible in 152 children (96%) (Table 3). Two children had
Discussion
Many studies have shown that LapAppy is at least as good as open appendectomy with several patient outcome benefits, including less postoperative pain and shorter LOS [3], [11], [12], [13]. Additional advantages include lower costs, particularly with increasing operative experience leading to shorter operative times [14] and reusable equipment obviating the need for expensive disposable supplies [3], [4]. Lastly, LapAppy may allow a shorter recovery time, returning patients to a productive
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Day Surgery in Children Undergoing Retroperitoneal Robot-assisted Laparoscopic Pyeloplasty: Is It Safe and Feasible?
2023, European Urology Open ScienceSame-day discharge after appendectomy for uncomplicated appendicitis in children: Potential barriers to increased utilization
2022, American Journal of SurgeryCitation Excerpt :The provision of high-value care for acute appendicitis in children is an impactful area in which to focus quality improvement efforts in the field of pediatric surgery.4 The findings of this study lend additional support to prior work suggesting that SDD is a safe and effective approach to decrease resource utilization among children with uncomplicated appendicitis.3,5–11,14–16,18,22–24 Parent and patient satisfaction has also been satisfactory with use of SDD.5,18,24,25
Advances in the Diagnosis and Management of Appendicitis in Children
2021, Advances in SurgeryCitation Excerpt :High caregiver satisfaction has been associated with same-day discharge protocols. In one prospective study of 158 patients, when asked at their 2-week follow-up visit, 92% of parents would choose same-day discharge again [51]. Duration and amount of prescribed opioids have been shown to be highly variable in children with appendicitis, and narcotic prescription has been associated with increased odds of emergency department revisit (13% vs 4.3%) and constipation requiring medical attention (2.1% vs 0%) in a retrospective study of 590 patients [52].
Post operative pediatric appendicitis nurse-driven discharge: Patient outcomes and nursing perspectives
2021, American Journal of SurgeryDistilling the Key Elements of Pediatric Appendicitis Clinical Practice Guidelines
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Presented at the 58th Annual Meeting of the British Association of Paediatric Surgeons, Belfast, Northern Ireland, July 20-22, 2011.