Our Summary

This study looks at whether the time of day a patient with acute appendicitis has their appendix removed affects the outcome of the surgery. The research was carried out at Tampere University Hospital between September 2014 and April 2017, with 1198 patients participating. The researchers looked at factors such as post-operation illness and death, length of hospital stay, and amount of bleeding during surgery. They divided the surgeries into two groups: those done during the day and those done at night.

The study found that there was no significant difference in the results of the surgery whether it was done during the day or at night. The overall rates of illness and death after the operation were 4.8% and 0.2% respectively, but these weren’t linked to the time of day the surgery was performed. The time of day also didn’t affect the length of the operation or the amount of bleeding. Interestingly, patients who had their surgery at night actually had a shorter hospital stay.

The only factor that was associated with worse outcomes was if the appendicitis was complicated. The findings suggest that an appendectomy, the surgical removal of the appendix, should be scheduled as soon as possible, without regard to the time of day. This could reduce delays, improving patient comfort, speeding up recovery, and reducing costs.

FAQs

  1. Does the time of day influence the outcomes among patients operated on for acute appendicitis?
  2. Is there a difference in outcomes between daytime and nighttime appendectomies?
  3. Does delaying an appendectomy affect patient recovery and comfort?

Doctor’s Tip

A helpful tip a doctor might tell a patient about appendectomy is to not delay the operation if possible, as a shorter delay can increase comfort, enable quicker recovery, and decrease costs. It is important to schedule the surgery for the next available slot to minimize any unnecessary delays.

Suitable For

Patients who are typically recommended for appendectomy are those who present with symptoms of acute appendicitis, such as abdominal pain, nausea, vomiting, and fever. In some cases, patients with chronic appendicitis or recurrent appendicitis may also be advised to undergo appendectomy. Additionally, patients with complications of appendicitis, such as perforation or abscess formation, may require urgent surgery. It is important for patients to consult with a healthcare provider to determine the most appropriate course of treatment for their specific condition.

Timeline

Before appendectomy:

  1. Patient experiences symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever.
  2. Patient visits a healthcare provider who performs a physical examination and may order imaging tests to confirm the diagnosis.
  3. Once appendicitis is confirmed, the patient is scheduled for an appendectomy procedure.

After appendectomy:

  1. Patient undergoes surgery to remove the inflamed appendix.
  2. Patient is monitored closely in the postoperative period for any complications such as infection or bleeding.
  3. Patient may experience pain and discomfort in the abdominal area, which can be managed with pain medication.
  4. Patient is discharged from the hospital once they are stable and able to tolerate oral intake.
  5. Patient is advised to rest and avoid strenuous activities for a certain period of time to allow for proper healing.
  6. Patient follows up with their healthcare provider for a postoperative check-up to ensure proper healing and recovery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about appendectomy include:

  1. What are the risks and benefits of undergoing an appendectomy?
  2. How urgent is the need for the surgery, and is there a recommended timeframe for getting the procedure done?
  3. What type of anesthesia will be used during the surgery?
  4. How long will the recovery process take, and what can I expect in terms of pain and discomfort?
  5. Are there any potential complications associated with the surgery that I should be aware of?
  6. Will there be any dietary or activity restrictions following the surgery?
  7. How long will I need to stay in the hospital after the surgery?
  8. Will there be any follow-up appointments or tests needed after the surgery?
  9. Are there any alternative treatment options to consider before undergoing an appendectomy?
  10. What is the success rate of appendectomy in treating acute appendicitis?

Reference

Authors: Mönttinen T, Kangaspunta H, Laukkarinen J, Ukkonen M. Journal: Scand J Surg. 2021 Jun;110(2):227-232. doi: 10.1177/1457496920938605. Epub 2020 Jul 14. PMID: 32662330