Early discharge after open appendicectomy

Area of Science:

• Surgical outcomes and patient recovery.
• Hospital administration and resource management.

Background:

• Increasing pressure to reduce hospital stays necessitates guidelines for common procedures.
• Early discharge protocols are being explored to optimize patient flow and hospital efficiency.
• This study aimed to assess the feasibility and safety of early discharge post-open appendicectomy.

Purpose of the Study:

• To evaluate the safety and feasibility of early discharge (within 48 hours) after open appendicectomy.
• To establish benchmarks for open appendicectomy outcomes for comparison with laparoscopic techniques.
• To identify factors influencing postoperative hospital stay duration.

Main Methods:

• Prospective study of 116 patients undergoing open appendicectomy over 4 months.
• Implementation of an early discharge program for uncomplicated cases (eating, walking, passed flatus).
• Multivariate regression analysis of age, gender, incision type, and pathology on discharge time.

Main Results:

• Median postoperative stay was 46 hours; perforation, midline laparotomy, and age prolonged stay.
• No adverse events directly linked to early discharge; wound infection rate was 7.5%.
• 88% of patients rated discharge timing as 'good' or 'excellent', with most returning to normal activities within 2 weeks.

Conclusions:

• Discharge at 2 days is feasible and safe for unperforated appendicectomies via right iliac fossa incision.
• Stool passage is not a prerequisite for discharge; early discharge is patient-accepted and cost-effective.
• Open appendicectomy remains a valid surgical option compared to laparoscopic approaches based on current evidence.