Our Summary

This research looked at how well the Brazilian public healthcare system handles cases of acute appendicitis in children. Appendicitis, an inflammation of the appendix, is the most common emergency surgery for kids. The study looked at all hospital stays for children up to 16 years old in 2022 who were diagnosed with acute appendicitis and had surgery.

They were particularly interested in the type of surgery performed, the cost of the hospital stay, and whether the patient died. They also classified hospitals based on how well-equipped they were to deal with pediatric cases.

The study found that there were almost 30,000 surgeries performed for acute appendicitis in children in 2022. The majority of these were open surgeries. Most of these surgeries took place in basic-facility general hospitals, with fewer in full-facility hospitals and pediatric hospitals.

Interestingly, the median cost of the hospital stay was highest in full-facility hospitals, followed by pediatric and basic hospitals. However, the cost difference between basic and pediatric hospitals was not significant.

Death was very rare, regardless of the type of hospital or surgery.

In simple terms, the study suggests that most surgeries for acute appendicitis in children are done in hospitals with limited resources for pediatric care. Despite this, they are generally safe and effective. Open surgeries are the most common type of procedure.

FAQs

  1. What was the most common type of appendectomy performed on pediatric patients in Brazil in 2022?
  2. How did the cost of hospitalization for pediatric appendectomies vary between basic, full, and pediatric facilities?
  3. What was the mortality rate for pediatric appendectomies across different levels of hospital infrastructure in Brazil in 2022?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric appendectomy is to ensure that the child receives adequate post-operative care, including pain management, wound care, and monitoring for any signs of infection or complications. It is important to follow all post-operative instructions provided by the medical team to ensure a smooth recovery process. Additionally, it is important to follow up with the healthcare provider for any necessary follow-up appointments or concerns.

Suitable For

Patients who are typically recommended pediatric appendectomy are those aged 0-16 years with a primary diagnosis of acute appendicitis. The study mentioned in the abstract found that the majority of pediatric appendectomies were performed in basic-facility general hospitals, followed by full-facility hospitals and pediatric hospitals. Open appendectomies were the most common surgical approach, and mortality was rare across all levels of hospital infrastructure. Therefore, pediatric patients with acute appendicitis may be recommended for appendectomy regardless of the type of hospital they are admitted to.

Timeline

Before pediatric appendectomy:

  1. Patient experiences symptoms of appendicitis such as abdominal pain, fever, nausea, and vomiting.
  2. Patient may undergo physical examination, blood tests, and imaging studies to confirm the diagnosis.
  3. Patient may receive antibiotics and be monitored closely for signs of worsening appendicitis.
  4. Surgical consultation is typically done to discuss the need for appendectomy.

After pediatric appendectomy:

  1. Patient undergoes appendectomy surgery, either open or laparoscopic.
  2. Patient is monitored in the recovery room and then transferred to a hospital room for further observation.
  3. Patient may experience pain and discomfort post-surgery, which is managed with pain medications.
  4. Patient is encouraged to start moving and walking as soon as possible to aid in recovery.
  5. Patient is discharged from the hospital once they are able to tolerate food, have normal bowel movements, and their pain is well-controlled.
  6. Patient is advised on post-operative care, including wound care, activity restrictions, and follow-up appointments.
  7. Patient typically recovers fully within a few weeks and can resume normal activities.

What to Ask Your Doctor

  1. What type of surgical approach will be used for my child’s appendectomy (open or laparoscopic)?

  2. How experienced is the surgical team in performing pediatric appendectomies?

  3. What are the potential risks and complications associated with the appendectomy procedure for a child?

  4. How long will my child need to stay in the hospital after the surgery?

  5. What is the expected recovery time for my child after the appendectomy?

  6. Will there be any restrictions on my child’s activities or diet following the surgery?

  7. What kind of pain management options will be available for my child during and after the surgery?

  8. How frequently will my child need follow-up appointments after the appendectomy?

  9. Are there any long-term effects or concerns we should be aware of after the appendectomy?

  10. What is the overall success rate and prognosis for pediatric patients who undergo appendectomy for acute appendicitis?

Reference

Authors: Moreira Melo PH, Telles L, Rangel AG, Marrazzo EB, Carroll M, Ferreira R, Mooney DP, Schnitman G. Journal: World J Surg. 2024 Nov;48(11):2678-2685. doi: 10.1002/wjs.12375. Epub 2024 Oct 22. PMID: 39438779