A prospective study of safety and satisfaction with same-day discharge after laparoscopic appendectomy for acute appendicitis.
OBJECTIVE
This study examines the safety and patient satisfaction in discharging children undergoing laparoscopic appendectomy (LapAppy) for acute appendicitis on the day of surgery.


METHODS
After institutional review board approval, data were collected prospectively for 158 consecutive patients undergoing LapAppy for simple appendicitis. Time from operation to discharge and complications were analyzed. At follow-up, parents completed a satisfaction survey. The Student t test was used for statistical analysis.


RESULTS
Laparoscopic appendectomy was performed in 158 children ranging from age 2 to 19 years (mean, 12 years) over a 6-month period. Single-port, single-instrument LapAppy was possible in 152 patients (96%). Eighty percent of patients (n = 126) were discharged on the day of surgery, a mean of 4.8 hours postoperatively (range, 1-12 hours). Of the remaining 32, 24 (75%) were admitted because the operation ended too late for postoperative discharge; 3 (9%), for medical reasons; and 5 (16%), when the families declined to leave. One hundred nine parents (87%) whose children went home postoperatively stated that they were happy with the expeditious discharge, whereas 17 (13%) felt nervous. In addition, 116 parents (92%) stated that, in retrospect, same-day discharge was preferable, whereas 10 parents (8%) were not sure that it was the best decision. None, however, would insist on admission if faced with the situation again. There were no major complications and no significant difference in the rate of umbilical wound infections for same-day discharge patients (2%) and admitted patients (3%).


CONCLUSIONS
Routine same-day discharge after pediatric LapAppy for acute appendicitis is safe, with good parent satisfaction.
Department of Pediatric Surgery, Miami Children's Hospital, Florida International University College of Medicine, Miami, FL 33155, USA.
Fuad
F
Alkhoury
Cathy
C
Burnweit
Leopoldo
L
Malvezzi
Colin
C
Knight
Jeannette
J
Diana
Raquel
R
Pasaron
JoAnne
J
Mora
Pradeep
P
Nazarey
Alexandra
A
Aserlind
Steven
S
Stylianos
D000293:Adolescent; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000523:psychology / Q000706:statistics & numerical data*; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010290:Parents / Q000523:psychology*; D010359:Patient Readmission / Q000706:statistics & numerical data; D010549:Personal Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult