Outpatient Laparoscopic Appendectomy for Acute Appendicitis

2012 ◽  
Vol 78 (2) ◽  
pp. 213-215 ◽  
Author(s):  
Cassadra L. Cash ◽  
Richard C. Frazee ◽  
Randall W. Smith ◽  
Matthew L. Davis ◽  
John C. Hendricks ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Laparoscopic Surgery ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Clinical Course ◽  
Wound Infections ◽  
Outpatient Management ◽  
Abdominal Bleeding ◽  
Superficial Wound ◽  
Uncomplicated Acute Appendicitis

Laparoscopic appendectomy is the widely accepted treatment for acute appendicitis. This approach offers the potential of less pain, shorter hospital stay, and quicker return to activities. Traditionally, patients are hospitalized for 24 hours after laparoscopic appendectomy. This practice can be questioned due to the good results of other outpatient laparoscopic surgery. A retrospective review of 119 patients undergoing laparoscopic appendectomy for uncomplicated acute appendicitis was undertaken from January through September 2009; outpatient and in-patient laparoscopic appendectomies were compared. Patients were selected for outpatient management based upon physician discretion and their clinical course in operation and recovery rooms. Forty-two patients were dismissed on the day of surgery and 77 were admitted for 1 to 5 days postoperatively. No significant differences in age, gender, and preoperative comorbidities between outpatient and inpatient groups were found. Postoperative complications occurred in 2.4 per cent of outpatients and 11.7 per cent of inpatients ( P = 0.16). Complications included superficial wound infections, urinary retention, urinary tract infection, intra-abdominal bleeding, pneumonia, and infected hematoma. Based upon this study, outpatient laparoscopic appendectomy can be performed safely in selected patients. This study provides the background for the present prospective protocol for routine outpatient laparoscopic appendectomy at our institution.

scholarly journals Endoscopic retrograde appendicitis therapy vs. Laparoscopic appendectomy for uncomplicated acute appendicitis

Endoscopy ◽  
2022 ◽  
Author(s):  
Baohong Yang ◽  
Lingjian Kong ◽  
Ullah Saif ◽  
Lixia Zhao ◽  
Dan Liu ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Hospital Length Of Stay ◽  
Adverse Event Rate ◽  
Recurrence Time ◽  
Endoscopic Retrograde ◽  
Significant Difference ◽  
One Year ◽  
Uncomplicated Acute Appendicitis ◽  
Matching Criteria

Background and study aims: To assess the efficacy and clinical outcomes of endoscopic retrograde appendicitis therapy (ERAT) versus laparoscopic appendectomy (LA) for patients with uncomplicated acute appendicitis (AA). Patients and methods: We adopted propensity score matching (1:1) to compare ERAT and LA patients with uncomplicated AA from April 2017 to March 2020. We reviewed a total of 2880 patients with suspected acute appendicitis, of whom 422 patients with uncomplicated AA met the matching criteria (ERAT, 79; LA, 343), yielding 78 pairs of patients. Results: The rate of curative treatment within one year after ERAT was 92.1%; 95% CI, [83.8% - 96.3%]. The percentage of Visual Analog Scale (VAS) ≤ 3 at six hours after treatment was 94.7%; 95% CI [87.2% - 97.9%] in the ERAT group, and significantly higher than that in the LA group 83.3%; 95% CI [73.5% - 90.0%]. Median operative/procedure time and median hospital length of stay in the ERAT group were significantly lower compared to the LA group. At one year, the median recurrence time was 50 days (IQRs, 25-127) in the ERAT group. The overall adverse event rate was 24.3%; 95% CI [14.8% - 33.9%] in the LA group and 18.4%; 95% CI [9.7% - 27.1%] in the ERAT group, with no significant difference between the two groups. Conclusions: ERAT is a technically feasible method to treat uncomplicated AA compared to LA.

scholarly journals Irrigation Versus Suction Alone During Laparoscopic Appendectomy for Uncomplicated Acute Appendicitis

2020 ◽  
Vol 36 (1) ◽  
pp. 30-34
Author(s):  
Tae Gyeong Lee ◽  
Soomin Nam ◽  
Hyung Soon Lee ◽  
Jin Ho Lee ◽  
Young Ki Hong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Postoperative Complication ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Multiple Logistic Regression Analysis ◽  
Operation Time ◽  
Site Infection ◽  
Uncomplicated Acute Appendicitis

Purpose: To compare the surgical outcomes of peritoneal irrigation versus suction alone during laparoscopic appendectomy and to identify the risk factors of surgical site infection in patients with uncomplicated acute appendicitis.Methods: Data from patients with uncomplicated acute appendicitis between January 2014 and March 2016 were reviewed. We compared the irrigation and suction alone groups with regard to the following parameters: postoperative complication incidence rate, length of hospital stay, operation time, time to flatus, time to diet commencement, and duration of postoperative antibiotic.Results: A total of 578 patients underwent laparoscopic appendectomy for uncomplicated acute appendicitis. Twenty-five patients were excluded from the analysis because of need for drain insertion, loss to follow-up, simultaneous surgery for another indication, presence of an appendix tumor, or pregnancy. A total of 207 patients (37.4%) had undergone irrigation, and 346 patients (62.6%) received suction alone during laparoscopic appendectomy. The preoperative fever rate was significantly higher in the irrigation group than in the suction alone group. Operative time was also significantly longer in the irrigation group than in the suction alone group (53.8 ± 18.5 minutes vs. 57.8 ± 21.4 minutes, P = 0.027). The postoperative complication rate was higher in the irrigation group than in the suction alone group (4.5% vs. 12.6%, P = 0.001). Multiple logistic regression analysis showed that irrigation and preoperative fever were risk factors for surgical site infection after laparoscopic appendectomy for uncomplicated acute appendicitis.Conclusion: There is no advantage to irrigating the peritoneal cavity over suction alone during laparoscopic appendectomy for uncomplicated acute appendicitis. Irrigation may actually prolong the operative time and therefore be detrimental.

Laparoscopic appendectomy protocol expedites management of uncomplicated acute appendicitis

2015 ◽  
Vol 221 (4) ◽  
pp. e86-e87
Author(s):  
Joseph A. Ibrahim ◽  
Alvaro M. Bada ◽  
Andrew C. Gratzon ◽  
Karen Safcsak ◽  
Chadwick P. Smith ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Uncomplicated Acute Appendicitis

scholarly journals Comparative study of single incision versus conventional three port laparoscopic appendectomy

2018 ◽  
Vol 5 (12) ◽  
pp. 3852 ◽  
Author(s):  
Sahil Rometra ◽  
Rahil Rometra ◽  
Neeraj Koul ◽  
R. K. Chrungoo
Keyword(s):  
Laparoscopic Surgery ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Single Incision ◽  
Open Appendectomy ◽  
Single Incision Laparoscopic Surgery ◽  
Abdominal Incision ◽  
Significant Difference

Background: Appendicitis is primarily a disease of adolescents and young adults with a peak incidence in the second and third decades of life. Appendectomy for appendicitis is the most commonly performed emergency operation in the world.For more than a century, open appendectomy remained the gold standard for the treatment of acute appendicitis.  Laparoscopic surgery has become popular universally during the last couple of decades.   Efforts are still being made to decrease abdominal incision and visible scars after laparoscopy.  Single incision laparoscopic surgery (SILS) is a new innovation allowing minimal access surgery to be performed through a single umbilical incision.Methods: It was a prospective study carried out on 50 patients diagnosed as acute appendicitis. They were divided into two groups of 25 each. One group underwent Conventional Laparoscopic Appendectomy (CLA) and other group underwent Single Incision Laparoscopic Surgery (SILS).  Results were compared with regard to mean operative time,   complications, post-operative pain and discomfort (vas score at 12 hours), post-operative morbidity, duration of hospital stay and condition at discharge and cosmesis.Results: There was no statistically significant difference between the two groups with respect to the parameters like postoperative pain, hospital stay and complication profile. However, operative time for SILS appendectomy were found to be significantly higher compared to conventional group.Conclusions: Single incision laparoscopic appendectomy using standard laparoscopic instruments is safe and effective, feasible surgery with better cosmetic results.

Enhanced recovery after surgery protocol allows ambulatory laparoscopic appendectomy in uncomplicated acute appendicitis: a prospective, randomized trial

2018 ◽  
Vol 33 (2) ◽  
pp. 429-436 ◽  
Author(s):  
Mario E. Trejo-Ávila ◽  
Sujey Romero-Loera ◽  
Eduardo Cárdenas-Lailson ◽  
Miguel Blas-Franco ◽  
Roberto Delano-Alonso ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Randomized Trial ◽  
Laparoscopic Appendectomy ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Prospective Randomized Trial ◽  
Uncomplicated Acute Appendicitis

Laparoscopic Appendectomy Protocol Expedites Management of Uncomplicated Acute Appendicitis

2017 ◽  
Vol 83 (6) ◽  
pp. 673-676
Author(s):  
Alvaro M. Bada ◽  
Joseph A. Ibrahim ◽  
Karen Safcsak ◽  
Andrew C. Gratzon ◽  
Chadwick P. Smith ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Ct Scan ◽  
Patient Care ◽  
Laparoscopic Appendectomy ◽  
Perioperative Management ◽  
Tertiary Care ◽  
Clinical Findings ◽  
Emergency Department Visits ◽  
Management Protocol ◽  
Uncomplicated Acute Appendicitis

Bed availability remains a constant struggle for tertiary care centers resulting in the use of management protocols to streamline patient care and reduce length of stay (LOS). A standardized perioperative management protocol for uncomplicated acute appendicitis (UA) was implemented in April 2014 to decrease both CT scan usage and LOS. Patients who underwent laparoscopic appendectomy for UA from April 2012 to May 2013 (PRE group) and April 2014 to May 2015 (POST group) were compared retrospectively. There were no differences in patient demographics or clinical findings between the groups. All patients in the PRE group had a CT scan for the diagnosis of appendicitis, whereas there was a 14 per cent decrease in the POST group (P = 0.002). There was a significant decrease in median LOS between the groups [PRE 1.3 vs POST 0.9 days; (P < 0.001)]. There was no difference in subsequent emergency department visits for complications [3 (4%) vs 4 (4%); P = 1.0] or 30-day readmission rate [1 (1%) vs 5 (5%); P = 0.22] between the groups. A standardized perioperative management protocol for UA patients significantly decreased CT scan utilization and LOS without compromising patient care.

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