Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri.
Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri; School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri.
J Surg Res. 2023 Aug;288:134-139. doi: 10.1016/j.jss.2023.02.018. Epub 2023 Mar 24.
Same-day discharge (SDD) after laparoscopic appendectomy for acute nonperforated appendicitis is safe, without an increased rate of postoperative complications, emergency department visits, or readmissions. We aimed to evaluate caregiver satisfaction with this protocol.
Patients discharged on the day of laparoscopic appendectomy for nonperforated acute appendicitis were identified between January 2022 and August 2022. Surveys to evaluate satisfaction with the protocol were distributed to the caregivers via email or text message 96 h after discharge. Telephone surveys were conducted if there were no responses to the initial online survey. The surveys assessed comfort with SDD, postoperative pain control adequacy, postoperative provider contact, and overall satisfaction. The protocol focused on avoidance of narcotics in the postoperative period and immediate return to a regular diet.
A total of 255 cases of nonperforated acute appendicitis underwent SDD. The survey response rate was 50.6% (n = 129). Most respondents were Caucasian (69.0%, n = 89) and male (51.9%, n = 67) with a median age of 12.0 y (IQR 8.9,14.7). The median postoperative length of hospital stay was 3.8 h (interquartile range [IQR] 3.2,4.8). The overall satisfaction rate was 91.5%, with 118 caregivers feeling satisfied with SDD. Most caregivers felt comfortable with the SDD protocol (89.9%, n = 116), with 22.5% (n = 29) calling a medical provider postoperatively. Approximately nine out of 10 caregivers reported that pain was adequately controlled (91.5%, n = 118). In contrast, those that were dissatisfied reported issues with pain control and anxiety with SDD after a surgical procedure.
Caregiver satisfaction and comfort with same-day discharge following laparoscopic appendectomy is high with appropriate anticipatory guidance and preoperative education.
腹腔镜阑尾切除术治疗急性非穿孔性阑尾炎的当日出院（SDD）是安全的，不会增加术后并发症、急诊就诊或再入院的发生率。我们旨在评估该方案对护理人员的满意度。
我们确定了 2022 年 1 月至 2022 年 8 月期间腹腔镜阑尾切除术治疗非穿孔性急性阑尾炎的当日出院患者。在出院后 96 小时，通过电子邮件或短信向护理人员分发了评估对该方案满意度的调查问卷。如果初次在线调查没有回应，则进行电话调查。调查问卷评估了对 SDD 的舒适度、术后疼痛控制的充分性、术后与提供者的联系以及整体满意度。该方案侧重于避免术后使用麻醉性镇痛药和立即恢复正常饮食。
共有 255 例非穿孔性急性阑尾炎患者行 SDD。调查问卷的回复率为 50.6%（n=129）。大多数受访者为白种人（69.0%，n=89）和男性（51.9%，n=67），中位年龄为 12.0 岁（IQR 8.9，14.7）。术后住院中位时间为 3.8 小时（IQR 3.2，4.8）。总体满意度为 91.5%，118 名护理人员对 SDD 表示满意。大多数护理人员对 SDD 方案感到满意（89.9%，n=116），22.5%（n=29）在术后致电医疗提供者。约十分之九的护理人员报告疼痛得到充分控制（91.5%，n=118）。相比之下，那些不满意的人报告了术后疼痛控制问题和对 SDD 的焦虑。
通过适当的预期指导和术前教育，腹腔镜阑尾切除术后当日出院得到了护理人员的高度认可和舒适感。
