Our Summary

This research paper is about a study conducted on children aged 6 to 13 years who underwent a specific type of surgery for appendicitis (laparoscopic appendectomy) in community hospitals. The study focused on hospitals that implemented a policy of sending patients home on the same day as their surgery (same-day discharge or SDD), even if the hospital had closed its pediatric unit.

The researchers compared the results from before and after the same-day discharge policy was implemented. They found that many more patients were sent home on the same day after the policy was introduced, without any increase in complications, emergency room visits, or readmissions within 30 days of the surgery. They also found that more patients were prescribed painkillers (narcotics) after their surgery once the policy was in place.

The conclusion drawn from the study was that it is safe and practical to send children home on the same day as their appendectomy, even if the hospital doesn’t have a dedicated pediatric unit. The introduction of the same-day discharge policy did not lead to higher rates of complications.

FAQs

  1. What age range of children was included in the study about laparoscopic appendectomy?
  2. Did the implementation of the same-day discharge policy increase complications, emergency room visits, or readmissions within 30 days of the surgery?
  3. What change was observed in the prescription of painkillers after the introduction of the same-day discharge policy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic appendectomy is to follow post-operative instructions carefully, including taking prescribed pain medication as directed, getting plenty of rest, staying hydrated, and gradually increasing physical activity as recommended by your surgeon. It’s important to listen to your body and contact your doctor if you experience any concerning symptoms such as persistent fever, severe pain, or unusual swelling. Follow-up appointments should also be attended to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended for laparoscopic appendectomy include those with uncomplicated appendicitis, which is characterized by inflammation of the appendix without any complications such as perforation or abscess formation. Laparoscopic appendectomy is preferred over open surgery for these patients due to its minimally invasive nature, resulting in shorter recovery times, less pain, and a quicker return to normal activities.

Additionally, patients who are in good overall health, have a low risk of surgical complications, and do not have any underlying medical conditions that may increase the risk of surgery are also good candidates for laparoscopic appendectomy. Children aged 6 to 13 years, as seen in the study mentioned above, can also be recommended for laparoscopic appendectomy if they meet the criteria mentioned.

It is important for patients to discuss their individual medical history, symptoms, and treatment options with their healthcare provider to determine the most appropriate course of action for their appendicitis.

Timeline

Before laparoscopic appendectomy:

  • Patient experiences symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever.
  • Patient goes to the emergency room or doctor’s office for evaluation.
  • Patient undergoes diagnostic tests such as blood work, ultrasound, or CT scan to confirm appendicitis.
  • Surgery is scheduled for the removal of the inflamed appendix.

After laparoscopic appendectomy:

  • Patient undergoes laparoscopic appendectomy, a minimally invasive surgery where small incisions are made in the abdomen to remove the appendix.
  • Patient is closely monitored in the recovery room for a few hours post-surgery.
  • Patient is encouraged to walk and drink fluids to aid in recovery.
  • Patient is discharged home on the same day as the surgery (if same-day discharge policy is implemented).
  • Patient is prescribed painkillers and instructed on post-operative care, including wound care and activity restrictions.
  • Patient follows up with their surgeon for a post-operative visit to ensure proper healing and address any concerns.

What to Ask Your Doctor

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

  1. What are the potential risks and complications associated with laparoscopic appendectomy?
  2. How long will the surgery take and what is the recovery time?
  3. Will I need to stay in the hospital overnight or can I go home the same day?
  4. What kind of pain management will be provided after the surgery?
  5. How soon can I return to normal activities, such as work or school?
  6. Are there any dietary restrictions or special instructions to follow after the surgery?
  7. Will I need a follow-up appointment after the surgery?
  8. What signs or symptoms should I watch for that may indicate a complication?
  9. How experienced is the surgical team in performing laparoscopic appendectomies?
  10. Are there any alternative treatments or surgical options available?

Reference

Authors: Lo HYA, Yang C, Rettig RL, Chung J, Shaul D, Sydorak R. Journal: J Pediatr Surg. 2022 Jul;57(7):1242-1248. doi: 10.1016/j.jpedsurg.2022.02.038. Epub 2022 Mar 14. PMID: 35379493