Advertisement

Is Surgery for Appendicitis Urgent or Emergent?

  • Jonathan L. HansenEmail author
Chapter

Abstract

Traditionally, emergent surgical resection was the mainstay of treatment for acute appendicitis. Recent research has shown that short delays up to 12–24 h are permissible for most patients without increased risk of appendiceal perforation or other complications. The acceptable delay prior to appendectomy may be shorter in children. “Outpatient appendectomy” is a viable management strategy in children and adults. This approach, in which the patient’s postoperative care is managed outside of the hospital, features low morbidity, a low readmission rate, and low cost.

Keywords

Appendicitis Appendiceal perforation Optimal timing Delay Outpatient appendectomy 

References

  1. 1.
    Bhangu A. Safety of short, in-hospital delays before surgery for acute appendicitis: multicentre cohort study, systematic review, and meta-analysis. Ann Surg. 2014;259:894–903.CrossRefGoogle Scholar
  2. 2.
    Fair BA, Kubasiak JC, Janssen I, et al. The impact of operative timing on outcomes of appendicitis: a national surgical quality improvement project analysis. Am J Surg. 2015;209:498–502.CrossRefGoogle Scholar
  3. 3.
    Bonadio W, Brazg J, Telt N, et al. Impact of in-hospital timing to appendectomy on perforation rates in children with appendicitis. J Emerg Med. 2015;49(5):597–604.CrossRefGoogle Scholar
  4. 4.
    Gurien LA, Wyrick DL, Smith SD, et al. Optimal timing of appendectomy in the pediatric population. J Surg Res. 2016;202:126–31.CrossRefGoogle Scholar
  5. 5.
    Stevenson MD, Dyan PS, Dudley NC, et al. Time from emergency department evaluation to operation and appendiceal perforation. Pediatrics. 2017;139(6):e20160742.CrossRefGoogle Scholar
  6. 6.
    Kim M, Kim SJ, Cho HJ. Effect of surgical timing and outcomes for appendicitis severity. Ann Surg Treat Res. 2016;91(2):85–9.CrossRefGoogle Scholar
  7. 7.
    Drake FT, Mottey NE, Farrokhi ET, et al. Time to appendectomy and risk of perforation in acute appendicitis. JAMA Surg. 2014;149(8):837–44.CrossRefGoogle Scholar
  8. 8.
    Litz CN, Stone L, Alessi R, et al. Impact of outpatient management following appendectomy for acute appendicitis: An ACS NSQIP-P analysis. J Pediatr Surg. 2017;  https://doi.org/10.1016/j.jpedsurg.2017.06.023. [Article In Press].CrossRefGoogle Scholar
  9. 9.
    Frazee R, Burlew CC, Regnar J, et al. Outpatient laparoscopic appendectomy can be successfully performed for uncomplicated appendicitis: a Southwestern Surgical Congress multicenter trial. Am J Surg. 2017;  https://doi.org/10.1016/j.amjsurg.2017.08.029. [Article In Press].CrossRefGoogle Scholar
  10. 10.
    Gurien LA, Burford JM, Bonasso PC, et al. Resource savings and outcomes associated with outpatient laparoscopic appendectomy for nonperforated appendicitis. J Pediatr Surg. 2017;  https://doi.org/10.1016/j.jpedsurg.2017.03.039. [Article In Press].CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.MedStar Franklin Square Medical CenterBaltimoreUSA

Personalised recommendations