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Outcome of early discharge protocol after appendectomy for pediatric acute appendicitis

Takahiro Jimbo1, Kouji Masumoto1, Hajime Takayasu1

  • 1Departments of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|April 5, 2017
PubMed

Insights

An early discharge protocol for pediatric acute appendicitis, combining early feeding and reduced-port surgery, proved safe and effective. This approach significantly reduced hospital stays for young patients with appendicitis.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery
  • Clinical Outcomes Research

Background:

  • Acute appendicitis is a common surgical emergency in children.
  • Traditional management may involve prolonged hospital stays.
  • Evaluating novel protocols can optimize patient care and resource utilization.

Purpose of the Study:

  • To assess the safety and efficacy of an early discharge protocol for pediatric acute appendicitis.
  • To evaluate the impact of reduced surgical stress through early feeding and minimally invasive techniques.
  • To determine the feasibility of shorter hospitalizations in this patient population.

Main Methods:

  • Implementation of a new protocol involving postoperative early feeding and reduced-port laparoscopic surgery.
  • Retrospective analysis of 36 pediatric patients with acute appendicitis treated between 2012 and 2013.
  • Monitoring of hematological markers (WBC, CRP, procalcitonin) and clinical outcomes, including hospital stay duration and complications.

Main Results:

  • The protocol involved 36 patients with a mean age of 10.3 years.
  • Mean hospital stay was significantly reduced to 2.1 days.
  • No postoperative complications were reported, with inflammatory markers normalizing by postoperative day 7.

Conclusions:

  • The early discharge protocol is a safe and effective strategy for managing acute non-perforated appendicitis in children.
  • Combining early feeding with reduced-port laparoscopic surgery minimizes surgical stress and facilitates early recovery.
  • This protocol offers a viable option for reducing hospital length of stay in pediatric appendicitis cases.
Abstract

Keywords:
acute appendicitisearly discharge protocolenhanced recovery after surgerylaparoscopic appendectomynon-perforated

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