Our Summary

This study looked at the timing of appendectomies (surgery to remove the appendix) and how it might affect outcomes for patients. Researchers looked at over 600 appendectomies performed between July 2018 and May 2020. They found that patients who had surgery 12 or more hours after being admitted to the hospital stayed longer in the hospital and were more likely to be readmitted within 30 days compared to those who had surgery within 12 hours. This difference remained when comparing patients who had surgery within 24 hours and those who waited longer.

Moreover, waiting more than 25 hours for surgery was linked to a greater chance of needing an open surgery (instead of less invasive laparoscopic surgery), longer surgery time, and longer hospital stay after surgery. Patients who waited more than 11 hours for surgery were also more likely to be readmitted within 30 days.

The study indicated that the best time to do an appendectomy is between 11 to 25 hours after admission for most patients. However, certain groups of patients, such as older individuals, those with certain anesthetic risk scores, and those who had symptoms for a long time before admission, might have worse outcomes if surgery is delayed.

FAQs

  1. Does the timing of an appendectomy affect the outcomes for patients?
  2. Does waiting more than 25 hours for an appendectomy increase the chance of needing an open surgery and result in a longer hospital stay?
  3. Who might have worse outcomes if an appendectomy is delayed?

Doctor’s Tip

Therefore, it is important to discuss with your doctor the best timing for your appendectomy based on your individual situation. It is important to seek medical attention promptly if you suspect you may have appendicitis to avoid complications and improve outcomes. Remember to follow your doctor’s recommendations for post-operative care to ensure a smooth recovery.

Suitable For

Patients who are typically recommended for appendectomy include those with acute appendicitis, which is inflammation of the appendix due to blockage of the appendix opening. Symptoms of acute appendicitis include sudden pain in the lower right abdomen, nausea, vomiting, and fever. In some cases, patients may also have a history of recurrent appendicitis or a ruptured appendix.

It is important for patients with suspected acute appendicitis to seek medical attention promptly, as delaying surgery can lead to complications such as appendix rupture, abscess formation, and peritonitis. Patients with severe symptoms, such as high fever, severe abdominal pain, and signs of peritonitis, are typically recommended for urgent appendectomy to prevent further complications.

Overall, appendectomy is a common and generally safe surgery with low complication rates. However, the timing of surgery can impact outcomes, as seen in the study mentioned above. Therefore, it is important for healthcare providers to carefully assess each patient’s individual situation and determine the optimal timing for appendectomy to ensure the best possible outcomes.

Timeline

  • Patient experiences abdominal pain and other symptoms such as nausea, vomiting, and fever
  • Patient seeks medical attention and is evaluated by a healthcare provider
  • Patient undergoes physical examination, blood tests, and imaging studies (such as ultrasound or CT scan) to diagnose appendicitis
  • Patient is admitted to the hospital for observation and preparation for surgery
  • Patient may receive antibiotics to reduce the risk of infection before surgery
  • Patient undergoes an appendectomy procedure, which can be done laparoscopically or through open surgery
  • After surgery, patient stays in the hospital for monitoring and recovery
  • Patient is discharged from the hospital once they are stable and able to tolerate food and drink
  • Patient follows up with their healthcare provider for post-operative care and to ensure proper healing
  • Patient may experience some pain and discomfort during the recovery period
  • Patient gradually resumes normal activities and diet as advised by their healthcare provider

Overall, the timeline of a patient’s experience with appendectomy involves the initial onset of symptoms, evaluation, surgery, recovery, and post-operative care to ensure a successful outcome.

What to Ask Your Doctor

  1. What is the optimal timing for my appendectomy based on my individual situation?
  2. How will delaying my surgery beyond the recommended timeframe impact my recovery and outcomes?
  3. Are there any specific risk factors or medical conditions that make it more urgent for me to have the surgery sooner rather than later?
  4. What are the potential risks and benefits of having laparoscopic versus open surgery for my appendectomy?
  5. How long can I expect to stay in the hospital after the surgery, and what is the typical recovery time?
  6. What steps can I take to reduce my risk of complications or readmission following the surgery?
  7. Are there any alternative treatment options to consider before proceeding with an appendectomy?
  8. How will my overall health and any preexisting conditions affect the timing and approach to my surgery?
  9. What can I expect in terms of pain management and post-operative care following the surgery?
  10. Are there any specific signs or symptoms I should watch for after the surgery that may indicate a potential complication?

Reference

Authors: Kabir T, Syn NL, Shaw V, Tan YHA, Chua HW, Ong LWL, Koh FH, Ladlad J, Barco JB, Wang P, Kui Y, Blasiak A, Zhao JJ, Ho D, Kam JH, Ngaserin S. Journal: Surgery. 2022 Sep;172(3):798-806. doi: 10.1016/j.surg.2022.04.021. Epub 2022 Jul 16. PMID: 35850731