Safety of Same-Day Discharge Compared to Overnight Observation Following Laparoscopic Appendectomy in the Pediatric-Aged Patient: A National Surgical Quality Improvement Program Project

Wakimoto, Mayuko; Miller, Rebecca; Shafy, Shabana Z.; Tumin, Dmitry; Veneziano, Giorgio; Tobias, Joseph D.

doi:10.1089/lap.2019.0046

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…19,21 Anyhow, we found in this study that laparoscopic appendicectomy proved nowadays is the most applicable and confident for difficult curious situations of inflammation and sequences of acute appendicitis with other intra-abdominal pathologies, as the laparoscopic appendectomy plays both diagnostic and therapeutic roles. 22,23 In these equivocal cases during laparoscopy, the process of laparoscopic appendectomy had been given another advantage to this approach which is also evidenced by Vettoretto and Agresta, 16 that they agreed that laparoscopy allows for superior visualization of the peritoneal cavity and exclusion of other pathology when the diagnosis of appendicitis is equivocal. 17,18,22,23 For this reason, laparoscopic appendectomy is often the preferred operation in women of childbearing age, in which the differential diagnosis for appendicitis is especially broad.…”

Section: Figure 1: Used Ports Sitesmentioning

confidence: 91%

“…22,23 In these equivocal cases during laparoscopy, the process of laparoscopic appendectomy had been given another advantage to this approach which is also evidenced by Vettoretto and Agresta, 16 that they agreed that laparoscopy allows for superior visualization of the peritoneal cavity and exclusion of other pathology when the diagnosis of appendicitis is equivocal. 17,18,22,23 For this reason, laparoscopic appendectomy is often the preferred operation in women of childbearing age, in which the differential diagnosis for appendicitis is especially broad. 14,17 On the other hand, a retrospective study by Sazhin et al 17 designed laparoscopic appendectomy advantages because of duration, accuracy, and stay in the hospital, moreover to certain pre-operative factors.…”

Section: Figure 1: Used Ports Sitesmentioning

confidence: 91%

“…It also identified that higher levels of C-reactive protein were associated with increased conversion rates. 20,23 Accordingly, they have developed a scoring model to estimate the risk of conversion to open during laparoscopic appendectomy based on clinically relevant and readily available pre-operative patient characteristics, including age ≥40, male sex, black race, diabetes, obesity, and a pre-operative diagnosis of complicated appendicitis. 19,20,24 Nevertheless, we did not observe the factors mentioned by the previous study other than few cases of moderately complicated mass which indebted laparotomy.…”

Section: Figure 1: Used Ports Sitesmentioning

confidence: 99%

“…2 0 , 2 4 , 2 5 Conclusively, our study results agree with most of the other studies worldwide that in cases of well chosen clinical situation, complication points of view, and economically in addition to doubtful cases, laparoscopic appendectomy is the option of choice for the management of such a case. 12,14,17,19,20,[22][23][24][25]…”

Section: Figure 1: Used Ports Sitesmentioning

confidence: 99%

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Evaluation of laparoscopic appendectomy proficiency in the management of acute appendicitis based on anatomy and pathologies

2021

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Background and objective: Laparoscopic appendectomy entered a controversial dilemma for choosing a perfect approach for appendectomy. Evaluation studies may resolve this controversy. This study aimed to evaluate laparoscopic appendectomy proficiency depending on anatomy and pathology. Methods: A total of 148cases managed by laparoscopic appendectomy were studied from 2014 to 2015.These cases were diagnosed clinically and by investigations. Parameters studied were operation duration, conversion rate, complications, associated pathology, rehabilitation, and histopathology. Results: By laparoscopy, the anatomical position of the appendix was easily recognized in 83.78%of cases, while the position of 16.22 %of cases was difficult because of the hidden appendix by adhesions, complications, and technical causes. The operation duration ranged between 34 and 60 minutes. Associated pathologies were demonstrated in 8% of cases. Regarding discharge from the hospital, 30% were on the same day, 50% on the first postoperative day, and 20% on the second postoperative day. Postoperative complications were 3% due to pelvic hematoma, port site infection, and bleeding. Postoperative pain was experienced in 3% of cases. The conversion rate was 4.7%. Rehabilitation was within 8-10 days. Conclusions: Laparoscopic appendectomy is safe and suitable for various anatomical positions of the inflamed appendix, suspicious, hidden, and in the presence of other pathologies with a properly placed port can play diagnostic and therapeutic roles. Significant superiority of laparoscopic appendectomy was observed in this study for the management of acute appendicitis and its pathological consequences. The conversion rate was 4.7% due to other pathologies. Keywords: Laparoscopic; Appendectomy; Anatomy; Pathology.

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Section: Figure 1: Used Ports Sitesmentioning

confidence: 91%

Section: Figure 1: Used Ports Sitesmentioning

confidence: 91%

Section: Figure 1: Used Ports Sitesmentioning

confidence: 99%

Section: Figure 1: Used Ports Sitesmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of laparoscopic appendectomy proficiency in the management of acute appendicitis based on anatomy and pathologies

2021

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“…The full text of 43 studies was retrieved and thoroughly read. Finally, 13 studies comprising of 32,021 children and adolescents were included in the review (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31).…”

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confidence: 99%

Feasibility of Same-Day Discharge After Appendectomy in Pediatric Patients: A Systematic Review and Meta-Analysis

Zheng

2022

Front. Pediatr.

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BackgroundTo compare the readmission rate, rate of urgent/unplanned visits to emergency, complication rate along with cost of health care among children and adolescents who were discharged the same day following a laparoscopic appendectomy and those who were not discharged on the same day.MethodsA systematic search was performed in the PubMed, Embase, and Scopus databases. Randomized controlled trials and studies, observational in design, were considered for inclusion. The included studies were conducted in children and adolescents with uncomplicated appendicitis undergoing laparoscopic appendectomy and compared outcomes of interest between patients that were discharged the same day (SDD group) following the operation and patients that were discharged within 2 days post-operatively (non-SSD group). Statistical analysis was performed using STATA software. Effect sizes were reported as pooled odds ratio (OR) or weighted mean difference (WMD) with 95% confidence intervals.ResultsA total of 13 studies with 32,021 children and adolescents were included. There was no significant difference in the risks of unplanned visit to the emergency department (OR 1.07, 95% CI: 0.78, 1.47), readmission (OR 0.83, 95% CI: 0.66, 1.05), reoperation/re-intervention (OR 1.73, 95% CI: 0.19, 16.2) and complications (OR 0.84, 95% CI: 0.67, 1.06) in both groups of patients. Patients in the SDD group had slightly lower risk of wound infection/complication (OR 0.74, 95% CI: 0.57, 0.96) compared to patients in the non-SDD group. Those with SDD had to incur comparatively lesser hospital expense (in USD) compared to those with no SDD (WMD −2587.4, 95% CI: −4628.3, −546.6).ConclusionIn children and adolescents with uncomplicated acute appendicitis undergoing laparoscopic appendectomy, same-day discharge is not associated with increased readmission risk, unplanned visits to emergency, and complications. Further, SDD is associated with lower cost of hospital care. Adoption of SDD in this subset of children and adolescents may be encouraged.Systematic Review Registration[www.crd.york.ac.uk/prospero], identifier [CRD420 22320539].

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Same-day discharge after laparoscopic appendectomy for non-perforated appendicitis is safe and cost effective

et al. 2021

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Safety of Same-Day Discharge Compared to Overnight Observation Following Laparoscopic Appendectomy in the Pediatric-Aged Patient: A National Surgical Quality Improvement Program Project

Cited by 8 publications

References 20 publications

Evaluation of laparoscopic appendectomy proficiency in the management of acute appendicitis based on anatomy and pathologies

Evaluation of laparoscopic appendectomy proficiency in the management of acute appendicitis based on anatomy and pathologies

Feasibility of Same-Day Discharge After Appendectomy in Pediatric Patients: A Systematic Review and Meta-Analysis

Same-day discharge after laparoscopic appendectomy for non-perforated appendicitis is safe and cost effective

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