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

Kashyap, Meghana V.; Reisen, Brianne; Hornick, Matthew A.; Nace, Gary W.; Laje, Pablo

doi:10.1007/s00383-021-04880-8

Cited by 11 publications

(2 citation statements)

References 19 publications

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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).…”

Section: Selection Of Articlesmentioning

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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Section: Selection Of Articlesmentioning

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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“…This transition was informed by data supporting the safety and feasibility of SDD in gynecological surgery [ 8 , 9 ]. Furthermore, lower costs and high patient satisfaction following SDD have contributed to this trend [ 10 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for unplanned admission following surgical repair of apical prolapse

et al. 2022

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Introduction and hypothesis Same-day discharge (SDD) is increasing in popularity following surgical repair of pelvic organ prolapse. The aim of this study was to evaluate factors associated with unplanned admission (UA) in women undergoing apical prolapse repair. Methods This retrospective, observational cohort study included patients who underwent apical prolapse repair and planned same-day discharge (SDD) between March 2019 and December 2021. The cohort was divided into two groups: patients who were discharged on the same day as surgery (SDD group) and patients who had an unplanned admission (UA group). Demographic, pre-, intra-, and post-operative data were collected. Risk factors associated with unplanned admission were evaluated using univariate and multivariate analyses. Results One-hundred and eighty-four cases of apical prolapse repair met the criteria for inclusion in the final analysis; this included 142 in the SDD group and 42 in the UA group. Patients in the UA group had significantly increased estimated blood loss, longer total operative time, later time arriving to the Post-Anesthesia Care unit (PACU) and longer overall stay in the PACU. No differences were observed in the 30-day complication rate, or 30-day unanticipated healthcare encounters, between groups. Multivariate analysis revealed that receiving ketorolac post-operatively was associated with a higher likelihood of SDD (OR=2.6, 95% CI 1.032–6.580, p =0.043). Conclusions Among women undergoing apical prolapse repair, same-day discharge was associated with comparable immediate and 30-day complication rates. Within our cohort, post-operative treatment with ketorolac was associated with greater likelihood of SDD.

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A new approach to laparoscopic appendectomy in children—clipless/sutureless Harmonic scalpel laparoscopic appendectomy

Pogorelić

Beara

Jukić

et al. 2021

Langenbecks Arch Surg

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

Cited by 11 publications

References 19 publications

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

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

Risk factors for unplanned admission following surgical repair of apical prolapse

A new approach to laparoscopic appendectomy in children—clipless/sutureless Harmonic scalpel laparoscopic appendectomy

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