A prospective treatment protocol for outpatient laparoscopic appendectomy for acute appendicitis
Journal of the American College of Surgeons, 05/24/2012
Cash CL et al. – An outpatient protocol for laparoscopic appendectomy significantly increased the rate of outpatient management with no increase in morbidity or mortality. This practice has now become standard of care at the institution.Methods
- Authors initiated a prospective outpatient protocol for laparoscopic appendectomy in July 2010 at the institution.
- All patients having laparoscopic appendectomy from July 2010 to March 2011 were included as protocol patients and were retrospectively reviewed.
- A separate group of patients having laparoscopic appendectomy from January to September 2009 were analyzed as historical controls.
- These 2 groups were compared for demographics, preoperative comorbidities, outpatient management, and postoperative morbidity by chi–square analysis, with a 0.95 confidence level for statistical significance.
- A total of 116 protocol patients were compared with 119 historical control patients.
- There were no significant differences in patient demographics, preoperative comorbidities, and pathologic findings between protocol patients and historical controls.
- Ninety–nine protocol patients (85.3%) had procedures as outpatients compared with 42 historical control patients (35.3%) (p < 0.05).
- Postoperative morbidity occurred in 6 protocol patients (5.2%) and 10 historical controls (8.4%) (p = NS).
- There were no readmissions or mortalities in the protocol group.