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World Journal of Surgery

, Volume 41, Issue 10, pp 2471–2479 | Cite as

Outpatient Appendectomy in an Emergency Outpatient Surgery Unit 24 h a Day: An Intention-to-Treat Analysis of 194 Patients

  • Adeline Aubry
  • Arnaud Saget
  • Gilles Manceau
  • Matthieu Faron
  • Mathilde Wagner
  • Christophe Tresallet
  • Bruno Riou
  • Olivier Lucidarme
  • Frédéric le Saché
  • Mehdi KarouiEmail author
Original Scientific Report

Abstract

Objective

To evaluate the feasibility and outcomes of patients operated on for uncomplicated acute appendicitis (UAA) in our 24-h emergency outpatient surgery unit.

Methods

This was a prospective observational study with intention-to-treat (ITT) analysis. From 12/2013 to 03/2015, all consecutive patients admitted for acute appendicitis (AA) were prospectively screened. A computed tomography or abdominal ultrasound confirmed the diagnosis of AA. Eligibility criteria for outpatient appendectomy were: UAA, no comorbidity, no physical or mental condition preventing participation in the study, absence of pregnancy, age older than 15 years, an accompanying adult person available for the hospital discharge and place of residence within 1 h of our hospital. In the case of intraoperative complication (abscess, local or general peritonitis) or complication of general anesthesia, patients were excluded from the outpatient pathway. The primary endpoint was the feasibility of outpatient appendectomy among all consecutive patients admitted for UAA.

Results

Of the 194 screened patients, 150 (77%) presented an UAA and 102 (68%) were eligible for an outpatient procedure. Thirteen eligible patients (13%) were excluded from the outpatient circuit (7 intraoperative and 6 postoperative contraindications). Outpatient appendectomy was performed in 89 patients, representing 59% (89/150) of the ITT population and 87% (89/102) of the eligible patients. The median length of hospital stay was 13 h. Postoperative complications were observed in six patients (6%).

Conclusions

This study reports a safe and feasible management of UAA. Our organization allows a short hospitalization for postoperative recovery without using conventional surgery beds and enables discharge throughout the night.

Keywords

Emergency Department Appendicitis Acute Appendicitis Laparoscopic Appendectomy Pelvic Abscess 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

We thank Dr. David Baker DM, FRCA, (Emeritus Consultant Anesthesiologist, Department of Anesthesiology and Critical Care, Hôpital Necker-Enfants Malades, Paris) for reviewing the manuscript. Support was provided solely from institutional and/or departmental sources.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no competing interests.

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Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  • Adeline Aubry
    • 1
  • Arnaud Saget
    • 2
  • Gilles Manceau
    • 2
  • Matthieu Faron
    • 3
  • Mathilde Wagner
    • 4
  • Christophe Tresallet
    • 3
  • Bruno Riou
    • 1
  • Olivier Lucidarme
    • 4
  • Frédéric le Saché
    • 5
  • Mehdi Karoui
    • 2
    Email author
  1. 1.Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Departments of Emergency Medicine and SurgerySorbonne Universités, UPMC University Paris 6ParisFrance
  2. 2.Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Departments of Digestive and Hepato-Pancreato-Biliary SurgerySorbonne Universités, UPMC University Paris 6ParisFrance
  3. 3.Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Departments of General and Endocrinology SurgerySorbonne Universités, UPMC University Paris 6ParisFrance
  4. 4.Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Departments of RadiologySorbonne Universités, UPMC University Paris 6ParisFrance
  5. 5.Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Departments of Anesthesiology and Critical CareSorbonne Universités, UPMC University Paris 6ParisFrance

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