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Effects of Timing of Appendectomy on the Risks of Perforation and Postoperative Complications of Acute Appendicitis

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Abstract

Background

It is generally believed that appendectomy should be performed immediately to prevent perforation and complications. Therefore, our objectives were to investigate the effect of timing of appendectomy on the incidence of perforation and complications.

Methods

We retrospectively reviewed the medical records of patients who underwent laparoscopic appendectomy between January 2014 and June 2015. The time from symptom onset to appendectomy was categorized into three periods: time from symptom onset to hospital admission (symptomatic time), time from admission to appendectomy (hospitalization time), and time from symptom onset to appendectomy [symptomatic period + hospitalization period (overall time)]. Multivariable analyses were performed to identify independent factors associated with perforation and complications.

Results

A total of 1753 patients were included in the present study. Perforation occurred in 28.2% of patients, and postoperative complications occurred in 10.0% of patients. Multivariable analysis showed that BT > 38 °C (P = 0.006), WBC count >13,000 cells/µl (P = 0.02), neutrophil ratio >80% (P < 0.001), and symptomatic time >24 h (P < 0.001) were independent factors of appendiceal perforation, while the neutrophil ratio >80% (P < 0.001) and symptomatic time >48 h (P = 0.003) were independently associated with complications.

Conclusions

The present study showed that the symptomatic time and overall time were significantly associated with perforation and complications, whereas hospitalization time was not associated with either perforation or complications.

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Acknowledgements

This research was supported by Hallym University Research Fund 2016(HURF-2016-52).

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Authors and Affiliations

  1. Department of Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 40, Sukwoo-Dong, Hwaseong-Si, Gyeonggi-Do, 445-170, Republic of Korea

    Jong Wan Kim, Dong Woo Shin, Jeong Yeon Kim & Sung Gil Park

  2. Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150 Seongan-ro, Gangdong-gu, Seoul, 05355, Republic of Korea

    Doo Jin Kim & Jun Ho Park

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  1. Jong Wan Kim
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Correspondence to Jun Ho Park.

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Kim, J.W., Shin, D.W., Kim, D.J. et al. Effects of Timing of Appendectomy on the Risks of Perforation and Postoperative Complications of Acute Appendicitis. World J Surg 42, 1295–1303 (2018). https://doi.org/10.1007/s00268-017-4280-4

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