Status of Day Care Laparoscopic Appendectomy in Developing Countries

Area of Science:

• Surgical Innovation
• Ambulatory Surgery
• Global Health

Background:

• Laparoscopic appendectomy as ambulatory surgery is not common, especially in resource-limited developing countries.
• Proven feasibility exists, but adoption is hindered by resource constraints and lack of data in these settings.

Purpose of the Study:

• To evaluate the safety and cost-effectiveness of same-day discharge following laparoscopic appendectomy in a resource-limited developing country.
• To promote the practice of ambulatory laparoscopic appendectomy in similar healthcare environments.

Main Methods:

• A prospective study involving 30 patients with symptomatic appendicitis undergoing laparoscopic appendectomy.
• Patients were assessed for same-day discharge eligibility, with follow-up on reasons for extended stay.

Main Results:

• 87% of patients were discharged on the same day; 13% were discharged the next morning.
• Only 3% of extended stays were for medical reasons (nausea, vomiting, pain); 10% were due to social reasons (attendant refusal).
• No significant postoperative complications or readmissions occurred; mean hospital stay was 11.20 hours; 80% experienced mild to moderate nausea/vomiting.

Conclusions:

• Routine same-day discharge after laparoscopic appendectomy is safe and feasible in developing countries.
• Social and cultural factors, rather than medical necessity, represent the main obstacle to same-day discharge.
• Effective communication with patients and attendants can overcome social hurdles and improve discharge rates.