Whyte Christine, Tran Eric, Lopez Monica E, Harris Burton H
Division of Pediatric Surgery, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY 10467, USA.
J Pediatr Surg. 2008 Nov;43(11):1970-2. doi: 10.1016/j.jpedsurg.2008.04.014.
Interval appendectomy may be advisable after successful nonoperative treatment of perforated appendicitis. To reduce the perceived morbidity of interval appendectomy, we sought to determine if the operation could be done on an outpatient basis. This study is focused on patient comfort and safety after laparoscopic interval appendectomy (LIA).
This is a retrospective review of the clinical course and length of stay of 24 children who had LIA during a 4-year period.
Of the 24 patients, 12 were discharged on the evening of surgery without incident. Nine additional patients were observed for the first postoperative night-2 for short episodes of temperature elevation, 3 for pain treated within the first 4 hours of recovery and requiring no further treatment, and 4 because the idea of outpatient appendectomy had yet to become popular. None of these patients was febrile overnight, none required narcotic or parenteral analgesics after leaving the recovery room, and all accepted feedings without nausea or vomiting. It is likely that all 9 of these patients could have been discharged on the day of operation. Three other patients stayed in the hospital for treatment of pain, low-grade fever, or slow resumption of feeding.
Of 24 patients, 21(88%) were or could have been discharged on the day of operation. When interval appendectomy is indicated, LIA can be performed safely as an outpatient surgical procedure in most children.
对于穿孔性阑尾炎成功进行非手术治疗后，择期阑尾切除术可能是可取的。为了降低人们所认为的择期阑尾切除术的发病率，我们试图确定该手术是否可以在门诊进行。本研究聚焦于腹腔镜择期阑尾切除术（LIA）后患者的舒适度和安全性。
这是一项对24名儿童在4年期间接受LIA的临床过程和住院时间的回顾性研究。
24例患者中，12例在手术当晚顺利出院。另外9例患者术后第一个晚上留院观察——2例因短时间体温升高，3例因在恢复的前4小时内接受了疼痛治疗且无需进一步治疗，4例是因为门诊阑尾切除术的想法尚未普及。这些患者无一例夜间发热，离开恢复室后均无需麻醉剂或非肠道镇痛药，且所有患者进食时均无恶心或呕吐。很可能这9例患者均可以在手术当天出院。另外3例患者因疼痛、低热或进食恢复缓慢而住院治疗。
24例患者中，21例（88%）在手术当天或本可以在手术当天出院。当需要进行择期阑尾切除术时，对于大多数儿童而言，LIA作为门诊手术可以安全进行。
