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Outcome of early discharge protocol after appendectomy for pediatric acute appendicitis
Author(s) -
Jimbo Takahiro,
Masumoto Kouji,
Takayasu Hajime,
Shinkai Toko,
Urita Yasuhisa,
Uesugi Toru,
Gotoh Chikashi,
Ono Kentaro,
Sasaki Takato
Publication year - 2017
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13290
Subject(s) - medicine , procalcitonin , white blood cell , acute appendicitis , appendicitis , c reactive protein , surgery , anesthesia , gastroenterology , inflammation , sepsis
Background The aim of this study was to evaluate the outcome of an early discharge protocol for pediatric acute appendicitis. Methods The present new early discharge protocol for appendicitis consisted of both postoperative early feeding and reduced‐port laparoscopic surgery, to reduce surgical stress. The outcome was studied in patients with acute appendicitis treated at the present institution from 2012 to 2013. Results Data on 36 acute appendicitis patients (mean age, 10.3 years) were collected. Operation time was 95 ± 27 min. Preoperatively, mean white blood cell ( WBC ) count was 13 850 ± 3644/μL; mean C‐reactive protein ( CRP ), 2.7 ± 2.9 mg/ dL ; and mean procalcitonin, 0.25 ± 0.37 ng/ mL . After surgery there was a significant decrease in WBC count, which fell to within the normal range; CRP peaked at 4.9 ± 3.2 mg/ dL on postoperative day ( POD ) 1. On POD 7, all of the hematological markers were within the normal range. There were no postoperative complications. Mean hospital stay was 2.1 ± 1.1 days. Mean frequency of oral painkiller use was 3.2 ± 3.3 times per person. Conclusions The present early discharge protocol is safe and effective for the management of acute non‐perforated appendicitis.