Laparoscopic appendectomy for acute appendicitis: a safe same-day surgery procedure?

Area of Science:

• General Surgery
• Gastroenterology

Background:

• Appendicitis is a common surgical emergency in the US, typically requiring inpatient admission.
• Recent trends include antibiotic therapy and incentivized short-stay procedures (e.g., 23-hour stays).

Purpose of the Study:

• To evaluate the safety and efficacy of early discharge after laparoscopic appendectomy.
• To compare outcomes for patients with length of stay (LOS) less than 24 hours versus longer stays.

Main Methods:

• Retrospective review of 84 laparoscopic appendectomies (June 2010 - October 2012).
• Exclusion of open conversions, concurrent diseases, and incidental appendectomies.
• Analysis of pathology, comorbidities, readmission rates, and LOS.

Main Results:

• 55 patients (65%) had LOS < 24 hours; 19 patients (22%) discharged < 7 hours.
• Patients discharged < 24 hours had one readmission (95% simple appendicitis).
• No significant difference in complications or readmissions between early (<24h) and longer LOS groups.

Conclusions:

• Early discharge (<24 hours) after uncomplicated laparoscopic appendectomy appears safe.
• Subgroup analysis suggests discharge from the postanesthesia care unit should be further evaluated.
• This supports exploring shorter hospital stays for select appendicitis patients.