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One-day appendectomy: more an opportunity than a challenge. A prospective protocol
Davina Perini1, Jacopo Martellucci2, Maximilian Scheiterle2
1Emergency Surgery Unit, Careggi University Hospital, Florence, Italy - davina.perini@gmail.com.
Background:
Short-stay and ambulatory pathways for laparoscopic appendectomy (LA) have gained increasing acceptance, yet conventional hospitalization remains common practice for acute appendicitis (AA). This study aimed to evaluate the safety and feasibility of a structured one-day LA protocol (discharge within 24 hours) and to refine patient selection criteria.
Methods:
A two-phase observational study was conducted, including a retrospective analysis followed by prospective validation of predefined eligibility criteria for one-day discharge.
Results:
Among 812 LA patients, early discharge was achieved safely without increased complications or readmissions. In the prospective phase, 132 patients met criteria and 90 were discharged within 24 hours. Logistic regression confirmed operator-dependent factors - especially drainage and longer operative time - as primary barriers to protocol adherence.
Conclusions:
A structured one-day LA protocol is safe, feasible, and effective in selected patients. The one-day pathway is now standard of care for uncomplicated AA at our institution.
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