Alkhoury Fuad, Malvezzi Leopoldo, Knight Colin G, Diana Jeannette, Pasaron Raquel, Mora Joanne, Aserlind Alexandra, Stylianos Steven, Burnweit Cathy
Department of Pediatric Surgery, Miami Children’s Hospital, Florida International University College of Medicine, Miami, FL 33155, USA.
Arch Surg. 2012 May;147(5):443-6. doi: 10.1001/archsurg.2012.132.
The outcomes of and parental satisfaction with same-day discharge in children undergoing laparoscopic appendectomy warrant making it the usual and customary pathway.
Prospective cohort study.
Tertiary care children's hospital.
Between July 1, 2010, and March 30, 2011, a total of 207 children were considered for same-day discharge after acute or interval laparoscopic appendectomy. The all-in-one single-incision single-instrument technique was used in 95.7% of children.
Same-day discharge vs overnight admission.
Operative details, postoperative length of stay, adverse events, and parental satisfaction.
Of 207 consecutive children undergoing acute (n = 186) or interval (n = 21) appendectomy, 162 (78.3%) were discharged on the day of surgery. The remaining 45 children were admitted overnight because the hour was too late for discharge in 35 (77.8%), medical indications dictated admission in 5 (11.1%), and social reasons required admission in 5 (11.1%). In all the children, oral medication alone was used for postoperative pain. The complication rates were similar in the same-day discharge group (8.0%) and in the admitted group (6.6%), as were the rates of urgent postoperative visits (7.4% vs 4.4%%) and the readmission rates (2.5% vs 2.2%) (P > .05 for all). The same-day discharge group had a reduced postoperative length of stay compared with the admitted group (mean, 5 vs 16 hours, P < .05). At the time of discharge, most parents (87.0%) stated they were happy with the expeditious discharge, whereas 8.0% indicated they felt nervous but were ultimately satisfied. In retrospect, 8 of 162 parents (4.9%) were not sure early discharge was best, but only 1 parent would insist on admission if faced with the situation again.
Routine same-day discharge after pediatric appendectomy seems safe, with good parental satisfaction.
接受腹腔镜阑尾切除术的儿童当日出院的结局及家长满意度证明应将其作为常规和惯常的出院途径。
前瞻性队列研究。
三级护理儿童医院。
在2010年7月1日至2011年3月30日期间，共有207名儿童在急性或择期腹腔镜阑尾切除术后被考虑当日出院。95.7%的儿童采用了一体化单切口单器械技术。
当日出院与过夜住院。
手术细节、术后住院时间、不良事件及家长满意度。
在207例连续接受急性（n = 186）或择期（n = 21）阑尾切除术的儿童中，162例（78.3%）在手术当日出院。其余45例儿童过夜住院，原因包括35例（77.8%）因时间太晚无法当日出院、5例（11.1%）因医学指征需要住院、5例（11.1%）因社会原因需要住院。所有儿童术后疼痛均仅使用口服药物。当日出院组（8.0%）和住院组（6.6%）的并发症发生率相似，术后紧急就诊率（7.4%对4.4%）和再入院率（2.5%对2.2%）也相似（所有P>0.05）。与住院组相比，当日出院组术后住院时间缩短（平均5小时对16小时，P<0.05）。出院时，大多数家长（87.0%）表示对快速出院感到满意，而8.
