title: Outcome of early discharge protocol after appendectomy for pediatric acute appendicitis.
abstract: BACKGROUND
  The aim of this study was to evaluate the outcome of an early discharge protocol for pediatric acute appendicitis.
  
  
  METHODS
  The present new early discharge protocol for appendicitis consisted of both postoperative early feeding and reduced-port laparoscopic surgery, to reduce surgical stress. The outcome was studied in patients with acute appendicitis treated at the present institution from 2012 to 2013.
  
  
  RESULTS
  Data on 36 acute appendicitis patients (mean age, 10.3 years) were collected. Operation time was 95 ± 27 min. Preoperatively, mean white blood cell (WBC) count was 13 850 ± 3644/μL; mean C-reactive protein (CRP), 2.7 ± 2.9 mg/dL; and mean procalcitonin, 0.25 ± 0.37 ng/mL. After surgery there was a significant decrease in WBC count, which fell to within the normal range; CRP peaked at 4.9 ± 3.2 mg/dL on postoperative day (POD) 1. On POD 7, all of the hematological markers were within the normal range. There were no postoperative complications. Mean hospital stay was 2.1 ± 1.1 days. Mean frequency of oral painkiller use was 3.2 ± 3.3 times per person.
  
  
  CONCLUSIONS
  The present early discharge protocol is safe and effective for the management of acute non-perforated appendicitis.
authors.affiliation: Departments of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Takahiro
authors.identifier: http://orcid.org/0000-0002-6711-3558
authors.initials: T
authors.lastname: Jimbo
authors.affiliation: Departments of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Kouji
authors.initials: K
authors.lastname: Masumoto
authors.affiliation: Departments of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Takayasu
authors.affiliation: Departments of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Toko
authors.initials: T
authors.lastname: Shinkai
authors.affiliation: Departments of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Urita
authors.affiliation: Departments of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Uesugi
authors.affiliation: Departments of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Chikashi
authors.initials: C
authors.lastname: Gotoh
authors.affiliation: Departments of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ono
authors.affiliation: Departments of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Takato
authors.initials: T
authors.lastname: Sasaki
mesh_terms: D000208:Acute Disease; D001062:Appendectomy / Q000379:methods; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002985:Clinical Protocols; D004750:Enteral Nutrition; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D010351:Patient Discharge; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D016896:Treatment Outcome
keywords: acute appendicitis; early discharge protocol; enhanced recovery after surgery; laparoscopic appendectomy; non-perforated