scholarly journals Risk Factors for Prolonged Hospitalization and Delayed Treatment Completion After Laparoscopic Appendectomy in Patients With Uncomplicated Acute Appendicitis

2021 ◽  
Author(s):  
Jiyoung Shin ◽  
Myong Hoon Ihn ◽  
Kyung Sik Kim ◽  
Sang Hyun Kim ◽  
Jihyoun Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Treatment Completion ◽  
Delayed Treatment ◽  
Prolonged Hospitalization ◽  
Uncomplicated Acute Appendicitis

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.

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.

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.

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 Risk factors for intra-abdominal abscess following laparoscopic appendectomy for acute appendicitis: a retrospective cohort study on 2076 patients

2020 ◽  
Vol 72 (4) ◽  
pp. 1175-1180
Author(s):  
Dario Tartaglia ◽  
Lorenzo Maria Fatucchi ◽  
Alessio Mazzoni ◽  
Mario Miccoli ◽  
Lorenzo Piccini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Abdominal Abscess

scholarly journals Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Maciej Walędziak ◽  
Anna Lasek ◽  
Michał Wysocki ◽  
Michael Su ◽  
Maciej Bobowicz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Events ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Hospital Readmission ◽  
Univariate Analysis ◽  
Complicated Appendicitis ◽  
Multivariate Model ◽  
Adverse Outcomes ◽  
Primary Procedure

Abstract Laparoscopic appendectomy (LA) for treatment of acute appendicitis has gained acceptance with its considerable benefits over open appendectomy. LA, however, can involve some adverse outcomes: morbidity, prolonged length of hospital stay (LOS) and hospital readmission. Identification of predictive factors may help to identify and tailor treatment for patients with higher risk of these adverse events. Our aim was to identify risk factors for serious morbidity, prolonged LOS and hospital readmission after LA. A database compiled information of patients admitted for acute appendicitis from eighteen Polish and German surgical centers. It included factors related to the patient characteristics, peri- and postoperative period. Univariate and multivariate logistic regression models were used to identify risk factors for serious perioperative complications, prolonged LOS, and hospital readmissions in acute appendicitis cases. 4618 laparoscopic appendectomy patients were included. First, although several risk factors for serious perioperative complications (C-D III-V) were found in the univariate analysis, in the multivariate model only the presence of intraoperative adverse events (OR 4.09, 95% CI 1.32–12.65, p = 0.014) and complicated appendicitis (OR 3.63, 95% CI 1.74–7.61, p = 0.001) was statistically significant. Second, prolonged LOS was associated with the presence of complicated appendicitis (OR 2.8, 95% CI: 1.53–5.12, p = 0.001), postoperative morbidity (OR 5.01, 95% CI: 2.33–10.75, p < 0.001), conversions (OR 6.48, 95% CI: 3.48–12.08, p < 0.001) and reinterventions after primary procedure (OR 8.79, 95% CI: 3.2–24.14, p < 0.001) in the multivariate model. Third, although several risk factors for hospital readmissions were found in univariate analysis, in the multivariate model only the presence of postoperative complications (OR 10.33, 95% CI: 4.27–25.00), reintervention after primary procedure (OR 5.62, 95% CI: 2.17–14.54), and LA performed by resident (OR 1.96, 95% CI: 1.03–3.70) remained significant. Laparoscopic appendectomy is a safe procedure associated with low rates of complications, prolonged LOS, and readmissions. Risk factors for these adverse events include complicated appendicitis, postoperative morbidity, conversion, and re-intervention after the primary procedure. Any occurrence of these factors during treatment should alert the healthcare team to identify the patients that require more customized treatment to minimize the risk for adverse outcomes.

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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