title: Outpatient laparoscopic appendectomy for acute appendicitis.
abstract: Laparoscopic appendectomy is the widely accepted treatment for acute appendicitis. This approach offers the potential of less pain, shorter hospital stay, and quicker return to activities. Traditionally, patients are hospitalized for 24 hours after laparoscopic appendectomy. This practice  can be questioned due to the good results of other outpatient laparoscopic surgery. A retrospective review of 119 patients undergoing laparoscopic appendectomy for uncomplicated acute appendicitis was undertaken from January through September 2009; outpatient and inpatient laparoscopic appendectomies  were compared. Patients were selected for outpatient management based upon physician discretion and their clinical course in operation and recovery rooms. Forty-two patients were dismissed on the day of surgery and 77 were admitted for 1 to 5 days postoperatively. No significant differences  in age, gender, and preoperative comorbidities between outpatient and inpatient groups were found. Postoperative complications occurred in 2.4 per cent of outpatients and 11.7 per cent of inpatients (P = 0.16). Complications included superficial wound infections, urinary retention,  urinary tract infection, intra-abdominal bleeding, pneumonia, and infected hematoma. Based upon this study, outpatient laparoscopic appendectomy can be performed safely in selected patients. This study provides the background for the present prospective protocol for routine outpatient laparoscopic  appendectomy at our institution.
authors.affiliation: Scott and White Healthcare, Temple, TX 76508, USA.
authors.forename: Cassadra L
authors.initials: CL
authors.lastname: Cash
authors.forename: Richard C
authors.initials: RC
authors.lastname: Frazee
authors.forename: Randall W
authors.initials: RW
authors.lastname: Smith
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Davis
authors.forename: John C
authors.initials: JC
authors.lastname: Hendricks
authors.forename: Ed W
authors.initials: EW
authors.lastname: Childs
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Abernathy
mesh_terms: D000208:Acute Disease; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D012189:Retrospective Studies; D016896:Treatment Outcome