Early discharge after appendicectomy in children.

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.