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Rapid recovery vs standard care in laparoscopic appendectomy: a prospective study on patient-reported outcomes
Tiia Mönttinen1,2, Maija-Liisa Kalliomäki1, Johanna Laukkarinen1,2
1Tampere University Hospital, Elämänaukio 2, Tampere, 33520, Finland.
Background:
Laparoscopic appendectomy for uncomplicated acute appendicitis traditionally requires postoperative hospitalization. Rapid recovery and same-day discharge protocols have been increasingly adopted, yet evidence regarding patient-reported outcomes is limited. This study aimed to compare a rapid recovery program with standard postoperative care, focusing on patient satisfaction, pain experience, and postoperative functional interference with daily activities.
Methods:
In this prospective, non-randomized observational study with sequential group allocation, 96 consecutive adults undergoing laparoscopic appendectomy for uncomplicated acute appendicitis at a single tertiary hospital were enrolled. Patients were allocated sequentially into standard care (n = 62, enrolled first) or a rapid recovery program (n = 34, enrolled in a subsequent phase). Outcomes included length of hospital stay, postoperative pain intensity (NRS 0-10), pain interference with daily activities, sleep quality, and overall satisfaction, assessed via structured telephone interviews conducted 3-5 days post-discharge.
Results:
Baseline demographics and comorbidities were comparable between groups. Median hospital stay was significantly shorter in the rapid recovery group compared with standard care (12 vs. 18 h, p < 0.001). All patients reported high overall satisfaction with care and pain management. Patients in the rapid recovery group reported lower worst pain (p = 0.049) and least pain (p = 0.006), while median pain was slightly higher (p = 0.004). Pain outcomes showed a mixed pattern that does not support a definitive conclusion regarding superiority of pain management in either group. Sleep disturbance due to pain was less common in the rapid recovery group (18% vs. 42%, p = 0.022). Nearly all patients expressed confidence in the rapid recovery protocol and would recommend it to others.
Conclusion:
Rapid recovery following laparoscopic appendectomy is feasible, well accepted, with high patient satisfaction and a modest reduction in hospital stay.
Trial Registration:
ISRCTN registered.
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