Our Summary

This study looked at the trends and outcomes of emergency appendix removal surgeries (appendectomies) in children in England. The researchers compared the results of these surgeries at general hospitals and specialist children’s hospitals over a decade (2001-2012). They found that the rate of these surgeries decreased over time, but there was also an increase in issues after surgery, such as complications, readmissions to the hospital, and unnecessary surgeries where the appendix was found to be normal (negative appendectomy). Children who had their surgery at a general hospital had a higher chance of these issues compared to those at specialist children’s hospitals. However, the hospital stay after surgery was longer at children’s hospitals compared to general hospitals. The study highlights the need for further improvements in surgical care for children in general hospitals.

FAQs

  1. What were the key findings of the study on pediatric appendectomies in England from 2001-2012?
  2. Did the study find any differences in outcomes between general hospitals and specialist children’s hospitals?
  3. What improvements does the study suggest for surgical care of children in general hospitals?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric appendectomy is to ensure they choose a hospital that specializes in pediatric surgery, as this can lead to better outcomes and lower risks of complications. It is important to weigh the potential benefits of specialized care against the longer hospital stay that may come with it. Additionally, parents should be aware of the signs of complications after surgery and seek medical attention if their child experiences any concerning symptoms.

Suitable For

Pediatric patients who are recommended for appendectomy typically have symptoms of appendicitis, such as abdominal pain, fever, nausea, and vomiting. In some cases, imaging tests such as ultrasound or CT scans may be used to confirm the diagnosis. Children with suspected appendicitis who do not improve with conservative treatment may be recommended for appendectomy to prevent the appendix from rupturing and causing a more serious infection.

Timeline

  1. Symptoms of appendicitis: Before the pediatric appendectomy, a patient may experience symptoms such as abdominal pain, loss of appetite, nausea, vomiting, and fever. These symptoms may worsen over time and prompt the need for surgery.

  2. Diagnosis and decision for surgery: The patient will undergo physical examination, blood tests, and imaging studies such as ultrasound or CT scan to confirm the diagnosis of appendicitis. Once diagnosed, the decision for surgery is made by the healthcare team.

  3. Pre-operative preparation: The patient will be prepared for surgery with fasting, intravenous fluids, and antibiotics. The surgical team will explain the procedure, risks, and benefits to the patient and their family.

  4. Pediatric appendectomy: The surgery is performed under general anesthesia, and the appendix is removed through a small incision in the abdomen (laparoscopic surgery) or through a larger incision (open surgery). The surgery typically takes about 30-60 minutes.

  5. Post-operative recovery: After the surgery, the patient will be monitored in the recovery room and then transferred to a hospital room. Pain medication, antibiotics, and fluids will be administered as needed. The patient will be encouraged to walk and resume normal activities gradually.

  6. Discharge and follow-up: The patient will be discharged from the hospital once they can tolerate food, have good pain control, and show signs of recovery. Follow-up appointments will be scheduled to monitor the healing process and address any concerns or complications.

What to Ask Your Doctor

  1. What are the common symptoms and signs of appendicitis in children?
  2. How is appendicitis diagnosed in children?
  3. What are the potential risks and complications associated with pediatric appendectomy?
  4. What is the difference in outcomes between having the surgery at a general hospital versus a specialist children’s hospital?
  5. How long is the typical recovery time for a child after undergoing an appendectomy?
  6. Are there any dietary or activity restrictions that my child should follow after surgery?
  7. What are the signs of complications that I should watch out for after my child’s surgery?
  8. How can I help my child manage any pain or discomfort after the surgery?
  9. What follow-up care or appointments will be necessary after the surgery?
  10. Are there any long-term effects or considerations to keep in mind after a pediatric appendectomy?

Reference

Authors: Giuliani S, Cecil EV, Apelt N, Sharland M, Saxena S. Journal: Ann Surg. 2016 Jan;263(1):184-90. doi: 10.1097/SLA.0000000000001099. PMID: 25563876