Timings for surgery of acute appendicitis | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2000]

Author(s):

1. Mohammed Amir: Armed Forces Hospital, King Abdulaziz Naval Base,Jubail, Kingdom of,Saudi Arabia

2. M. H. Raja: Armed Forces Hospital, King Abdulaziz Naval Base,Jubail, Kingdom of,Saudi Arabia

Abstract:

Early appendectomy is traditionally considered the treatment of choice for acute appendicitis. Recently many reports have shown that postponing surgery overnight for such cases till the following morning is safe without increase in the rate of complications. In our hospital, too, it has been our practice for those patients admitted with non-complicated acute appendicitis who come in the evening or night to delay their surgery till the following day. A retrospective study was undertaken to see the impact of this policy on the rate of complicated cases, postoperative complications and hospital stay. It included 270 patients undergoing surgery for acute appendicitis from January, 1995 through December 1999. The patients were grouped into two categories; Group A included (84) cases who were operated within 6 hours of admission and Group B comprised the rest (186) who were operated after 6 hours. In Group A, 85.7% cases had acute uncomplicated appendicitis, 9.5% complicated (perforated and gangrenous) and 4.76% had normal appendices. In Group B, there were 83.87% cases of acute appendicitis, 8.6% complicated and 6.45% normal appendices. In Group A13.1% cases had postoperative complications as against 5.09% in Group B. The mean hospital stay, too, was comparable in both the groups (4.16 days in Group A and 4.8 days in Group B). The data suggests that elective overnight delay in appendectomy is safe without any increase in the rate of complications, postoperative morbidity and hospital stay.

Page(s): 295-297

DOI: DOI not available

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 10, Issue: 8, Year: 2000

Keywords:

Appendicitis Appendectomy Postoperative complications

References:

[1] Fitz RH .1886 .Perforating inflammation of the vermiform appendix; with special reference to its early diagnosis and treatment. AmJMedSci, 92 : 321-46.

[2] . .Presidential address: A history of appendicitis. AnnSurg\^Z3\, 197 : 495-506.

[3] .1995 .. Analysis of 8651 appendicectomies in England and Wales during 1992. BrJSurg, 82 : 933.

[4] Shami IH .1992 .Analysis of early appendectomies for suspected acute appendicitis: A prospective study. JSurg, 3(4) : 25-28.

[5] . .Observation versus operation for abdominal pain in the right lower quadrant. Am J Surg, : .

[6] .1992 .. The report of the national confidential enquiry into Perioperative deaths, : .

[7] .1993 .Is it necessary to perform appendectomy in the middle of the night in children. BMJ, 306 : 1108.

[8] McLeanAD .1993 .Timing of presentation, time of operation and unnecessary appendectomy. BMJ, : 306-7.

[9] Young DV .1989 .Results of urgent appendectomy for right lower quadrant tenderness. JSurg, 1157 : 428-30.

[10] . .Improvement in diagnosis and management. Am SurgV&\ \, 57 : 282-5.

[11] . .Effect of transfer on outcome in patients with appendicitis. AnnEmerg4, 71997 : 467-73.

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