title: The AQC database represents a useful tool for quality control and scientific analysis of acute appendicitis.
abstract: BACKGROUND
  To ensure a high quality of care in surgery, many surgical departments in Switzerland are members of the working group for quality assurance in surgery (AQC). The purpose of this study was to assess the value of the AQC database as a tool for quality assurance and a source for scientific studies. We had two hypotheses. Firstly that the percentage of laparoscopic appendectomies would have increased over time without an increase in the complication rate and secondly that these procedures would primarily have been performed by residents.
  
  
  METHODS
  All appendectomies performed at the Kantonsspital Olten between 2001 and 2006 were prospectively recorded in the AQC database.
  
  
  RESULTS
  684 appendectomies were performed. We recorded a clear increase in the use of laparoscopic interventions from 51 to 81%. Ninety three percent of these appendectomies were performed by residents or junior faculty members. The main complication were surgical site infection in 3.6% of the open procedures as compared to none in laparoscopic procedures (p <0.001). Intra-abdominal abscess formation was recorded in 2.7% of laparoscopic procedures as compared to 1.8% in open surgery (p = 0.608). The overall complication rate in the study was 5.4% with no statistical difference between open (6.5%) and laparoscopic (4.7%) surgery (p = 0.305).
  
  
  CONCLUSIONS
  The study clearly shows that the AQC-database offers a wide variety of possibilities for quality assurance and scientific analyses. Our data demonstrate that laparoscopic procedures clearly increased from 2001 to 2006. Appendectomies were mainly performed by residents and junior faculty members. Laparoscopic appendectomy is a safe procedure with a low complication rate and should be applied as a teaching operation during the surgical training.
authors: Department of Surgery, Kantonsspital Olten, Switzerland. uvonholzen@uhbs.ch
authors: Urs
authors: U
authors: von Holzen
authors: Andre
authors: A
authors: Gehrz
authors: Lukas
authors: L
authors: Meier
authors: Markus
authors: M
authors: Zuber
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology; D000293:Adolescent; D000328:Adult; D001062:Appendectomy / Q000009:adverse effects / Q000592:standards* / Q000706:statistics & numerical data; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data; D016208:Databases, Factual; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000592:standards* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011785:Quality Assurance, Health Care / Q000379:methods*; D013530:Surgical Wound Infection / Q000209:etiology; D013557:Switzerland; D055815:Young Adult