[Management of acute appendicitis : Evidence for prompt surgical treatment?]

Abstract

Background: Acute appendicitis is a common disease which requires immediate surgical treatment of the focus of inflammation. So far there are no reliable data on how much time can pass between hospitalization, indications for surgery and initiating surgery without an increased risk of morbidity and mortality for the patient.

Objective: The aim of this study was to investigate how much time can lapse between admission and initiation of surgery for acute appendicitis while still providing patient safety and no increase in complication rates.

Material and methods: This retrospective analysis investigated the management of all patients who underwent appendectomy under the suspicion of acute appendicitis. Besides the time span between hospital admittance and beginning of the operation (admission to incision time, AIT), anamnestic, diagnostic, technical and perioperative data were assessed and statistically analyzed (mean ± SD).

Results: From January 2008 to April 2013 a total of 655 patients underwent appendectomy. The mean AIT was 7 h and the rate of negative appendectomy was 9.8 %. The mean hospitalization period was 5.9 ± 8.7 days with a postoperative stay of 5.2 ± 7.1 days. A comparison of the subgroups stratified by increasing AIT showed that there was no increased probability for perforation or postoperative complications with an AIT of up to 8 h.

Discussion: This retrospective cohort study showed that appendectomy should be performed within the first 8 h after hospitalization of the patient.

Keywords: Acute appendicitis; Admittance to incision time; Complication; Perforation; Surgical management.