title: [Fast track protocol for children undergoing appendicectomy].
abstract: BACKGROUND
  Multiple approaches to the treatment of simple and complicated (gangrenous or perforated) appendicitis in children have been promoted. Our goal is to develop a new protocol for these patients that allows shorter hospital stays without increasing complications rates.
  
  
  METHODS
  Prospective collected data of patients undergoing appendicitis treated according to the new protocol for a period of 7 months were reviewed. This protocol consists on antibiotic prophylaxis in all cases continued with triple antibiotic regimen in complicated appendicitis. Antibiotics were stopped when specific clinical and laboratory criteria were met. Outcomes are compared to a historical group of patients treated under standard protocol (antibiotic prophylaxis followed by 48 hours of dual antibiotic therapy in simple appendicitis or 5 day-course of triple antibiotic therapy in complicated as postooperative antibiotic regimen).
  
  
  RESULTS
  A total of 196 patients (96 current group and 100 historical group) were reviewed. In simple appendicitis average length of postoperative hospitalization was significantly lower in the current group (no statistical difference). 52.9% of complicated appendicitis in the current group were discharged home before 5th day without increasing the complication rate. When a wound infection or intraabdominal abscess occurs thrombocytosis (52%) and prolonged vomiting are the most frequent symptoms.
  
  
  CONCLUSIONS
  No further postoperative treatment is needed in simple appendicitis. In complicated appendictis a short course of antibiotics according to clinical and laboratory criteria allows early discharge without major morbidity. Prolonged postoperative vomiting and thrombocytosis suggest infectious complications.
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: M
authors: M
authors: Fanjul
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: L
authors: L
authors: Pérez
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: J
authors: J
authors: Cerdá
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: M
authors: M
authors: Zornoza
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: R
authors: R
authors: Rojo
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: I
authors: I
authors: Simal
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: M A
authors: MA
authors: García-Casillas
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: C
authors: C
authors: Corona
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: D
authors: D
authors: Peláez
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: E
authors: E
authors: Molina
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: A
authors: A
authors: Parente
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: S
authors: S
authors: Rivas
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: J M
authors: JM
authors: Angulo
authors: Hospital General Universitario Gregorio Marañón. Madrid.
authors: E
authors: E
authors: De Tomás
keywords: Appendicitis; Fast track