Day-care laparoscopic appendectomies.
OBJECTIVE
To demonstrate the safety of laparoscopic appendectomy in a day-care setting and to compare patients selected for laparoscopic versus open appendectomy.


METHODS
A retrospective, nonrandomized study.


METHODS
A community hospital in a small town in British Columbia.


METHODS
Ninety-four consecutive patients with a clinical diagnosis of acute appendicitis.


METHODS
Each patient underwent laparoscopic or open appendectomy as selected by the operating surgeon.


METHODS
Duration of operation and of hospital stay, morbidity and mortality.


RESULTS
The average operating time was 32 minutes for open appendectomy and 36 minutes for laparoscopic appendectomy. Two (4%) of the 52 patients who had a laparoscopic appendectomy had significant complications; 1 of them required reoperation for intra-abdominal abscess. Thirty-nine (75%) of the laparoscopic appendectomies were done as day-care procedures. The average length of stay for the remaining patients was 2.1 days. The overall complication rate for patients who underwent open appendectomy was 20%. The average length of stay for these patients was 3.2 days; no patient was discharged within 24 hours.


CONCLUSIONS
Laparoscopic appendectomy can be safely performed as a day-care procedure, even for selected patients with gangrenous or perforated appendices. Patients typically selected for open appendectomy include children and those with more advanced infection.
Brosseuk
D T
DT
Cariboo Memorial Hospital, Williams Lake, BC. dbrosseu@stardate.bc.ca
Bathe
O F
OF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000592:standards*; D001062:Appendectomy / Q000379:methods* / Q000592:standards*; D001064:Appendicitis / Q000601:surgery*; D001955:British Columbia; D002648:Child; D006801:Humans; D007416:Intestinal Perforation / Q000601:surgery; D010535:Laparoscopy; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012449:Safety