Pregledni rad
https://doi.org/10.26800/LV-145-supl1-25
The same day discharge after laparoscopic appendectomy for simple appendicitis in pediatric patients
Miro Jukić
orcid.org/0000-0002-8853-4335
; Klinika za dječju kirurgiju, Klinički bolnički centar Split, Split
Alexander Tesch
Jakov Todorić
Tomislav Šušnjar
Klaudio-Pjer Milunović
orcid.org/0000-0002-2650-531X
Tomislav Barić
Zenon Pogorelić
Sažetak
Introduction: One-day surgery has been widely adopted for many elective laparoscopic procedures in pediatric patients. Study aimed to evaluate the effectiveness and safety of hospital discharge within 24h in children who received laparoscopic appendectomy (LA) for uncomplicated acute appendicitis (uAA). Materials and Methods: From March 1st 2021 to May 1st 2022, 180 patients, who were discharged within 24h after LA for uAA, were included in this prospective. Primary outcomes were the safety of discharge from hospital within 24h after LA for uAA, as well as the parental satisfaction with this protocol. Secondary outcomes included the rate of unplanned return to the operating room, readmissions, complication rate and the cost-effectiveness analysis. For each patient, demographic data, preoperative evaluation (physical examination, laboratory data, imaging), surgery duration, postoperative and intraoperative complications, hospitalization time and pain levels, as well as parental satisfaction with this protocol, were recorded. Results: The median age was 11 years [interquartile range (IQR) 10, 14]. The majority of the patients (63.8%) were males. The median length of hospital stay after surgery was 15 h (IQR 12,19). The highest satisfaction level, at discharge, was recorded in most of the parents (n=155; 86.1%), while the remaining 25 (13.9%) expressed mediocre satisfaction levels. The median pain levels according to a visual analogue scale for all postoperative days were low (range 0–4). There was unplanned readmission, before the seventh postoperative day, in four patients (2.2%), cause of postoperative intraabdominal abscess. All were treated conservatively. Majority of the respondents (n=175; 97.2%) expressed the highest satisfaction level, on the seventh postoperative day, in outpatient follow-up examination. Conclusions: Same-day discharge after LA for uAA in children is safe and feasible. Parental satisfaction with this protocol was very high. With correct protocol and parent education, children who are operated for uAA by laparoscopy may be successfully treated this way.
Ključne riječi
ACUTE APPENDICITIS; ONE-DAY DISCHARGE; COMPLICATIONS; PEDIATRIC SURGERY; CHILDREN; LAPAROSCOPIC APPENDECTOMY; SAME-DAY DISCHARGE
Hrčak ID:
300849
URI
Datum izdavanja:
17.4.2023.
Posjeta: 467 *