Early discharge after appendicectomy in children

Abstract

Objective: To confirm that "day-care" appendicectomy is safe in children.

Design: Prospective study.

Settings: Paediatric hospitals, Brazil.

Subjects: 144 children who required removal of the appendix.

Interventions: Standard muscle splitting appendicectomy.

Main outcome measures: Hospital stay, use of antibiotics, and complications.

Results: 124 patients (86%) were discharged within 24 hours of operation. In all patients the appendicitis was confirmed and grouped according to histopathological findings (72 inflamed, 26 gangrenous and 26 perforated). 86 patients (60%) were given metronidazole one hour before operation as prophylaxis against postoperative abscess formation. 78 (54%) were given no antibiotics in the postoperative period. 2 patients were readmitted for drainage of intraperitoneal abscesses and 10 had subcutaneous abscesses drained as outpatients during the early postoperative period. The overall infective complication rate was 8% (n = 12), which is comparable with large series of appendicectomy in children.

Conclusions: "Day-care" appendicectomy is safe and feasible in children, as it avoids a long hospital stay and increased costs with no additional risk.