Perioperative Morbidity in Acute Appendicitis: Is Delayed Appendectomy Still an Option?

Acute appendicitis is one of the most common causes of acute abdominal pain worldwide. Although several studies have tried to investigate effects of delayed appendectomy, robust recommendations on this topic are still lacking.The aim of this retrospective study was to evaluate the correlation between delayed surgical treatment in acute appendicitis and postoperative complications.

A 5-year retrospective study was conducted including all patients aged >15 years who underwent laparoscopic appendectomy. Groups were categorized according to the time of in-hospital delay (IHD) (time from hospital admission to surgical incision) as Group A: Early appendectomy (IHD <8 hours) and Group B: Delayed appendectomy (IHD ≥8 hours). Demographics and clinical characteristics, operative time, appendicitis grading score according to disease severity score, and clinical outcomes were considered for analyses.

A total of 290 patients were included for statistical analysis: 145 patients (50%) in Group A and 145 patients (50%) in Group B. Patients' baseline characteristics were similar between groups. There were no statistically significant differences between groups A and B in terms of operative time (72.60 minutes versus 72.47 minutes, P = .061), use of drain (53.8% versus 46.2%, P = .731), postoperative complications (47.4% versus 52.6%, P = .812), and length of hospital stay (2.39 [1-24] versus 2.79 [1-12], P = .645). There were no 30-day readmissions in both groups. Overall mortality was 0.3%.

Our results suggest that an IHD of ≥8 hours does not significantly increase the risk of complicated appendicitis, the incidence of perioperative complications, postoperative length of stay, or mortality.