• Fuad Alkhoury, Leopoldo Malvezzi, Colin G Knight, Jeannette Diana, Raquel Pasaron, Joanne Mora, Alexandra Aserlind, Steven Stylianos, and Cathy Burnweit.
• Department of Pediatric Surgery, Miami Children’s Hospital, Florida International University College of Medicine, Miami, FL 33155, USA.
• Arch Surg. 2012 May 1; 147 (5): 443-6.

HypothesisThe outcomes of and parental satisfaction with same-day discharge in children undergoing laparoscopic appendectomy warrant making it the usual and customary pathway.DesignProspective cohort study.SettingTertiary care children's hospital.PatientsBetween July 1, 2010, and March 30, 2011, a total of 207 children were considered for same-day discharge after acute or interval laparoscopic appendectomy. The all-in-one single-incision single-instrument technique was used in 95.7% of children.InterventionsSame-day discharge vs overnight admission.Main Outcome MeasuresOperative details, postoperative length of stay, adverse events, and parental satisfaction.ResultsOf 207 consecutive children undergoing acute (n = 186) or interval (n = 21) appendectomy, 162 (78.3%) were discharged on the day of surgery. The remaining 45 children were admitted overnight because the hour was too late for discharge in 35 (77.8%), medical indications dictated admission in 5 (11.1%), and social reasons required admission in 5 (11.1%). In all the children, oral medication alone was used for postoperative pain. The complication rates were similar in the same-day discharge group (8.0%) and in the admitted group (6.6%), as were the rates of urgent postoperative visits (7.4% vs 4.4%%) and the readmission rates (2.5% vs 2.2%) (P > .05 for all). The same-day discharge group had a reduced postoperative length of stay compared with the admitted group (mean, 5 vs 16 hours, P < .05). At the time of discharge, most parents (87.0%) stated they were happy with the expeditious discharge, whereas 8.0% indicated they felt nervous but were ultimately satisfied. In retrospect, 8 of 162 parents (4.9%) were not sure early discharge was best, but only 1 parent would insist on admission if faced with the situation again.ConclusionRoutine same-day discharge after pediatric appendectomy seems safe, with good parental satisfaction.

13 keywords...

hide…