Pogorelić Zenon, Janković Marendić Ivana, Čohadžić Tin, Jukić Miro
Department of Pediatric Surgery, University Hospital of Split, 21000 Split, Croatia.
Department of Surgery, School of Medicine, University of Split, 21000 Split, Croatia.
Children (Basel). 2023 Apr 20;10(4):750. doi: 10.3390/children10040750.
: To evaluate the clinical outcomes and complication rate of laparoscopic appendectomy in children operated on during the daytime versus nighttime. : A total of 303 children who underwent laparoscopic appendectomy for acute appendicitis between 1 January 2020 and 31 December 2022 were enrolled in this retrospective study. The patients were divided into two study groups. The first group consisted of the patients who underwent laparoscopic appendectomy during the day shift from 07:00-21:00 ( = 171), while the patients in the second group underwent laparoscopic appendectomy during the night shift from 21:00-07:00 ( = 132). The groups were compared for baseline clinical and laboratory data, treatment outcomes, and complications. The Mann-Whitney U test was used to compare continuous variables, while the Chi-square test was used to compare categorical variables. A two-sided Fisher's exact test was used when the frequency of events in a certain cell was low. All values less than 0.05 were considered significant. : The proportion of complicated appendicitis was almost the same in both patient groups ( = 63, 36.8% vs. = 49, 37.1%, = 0.960). Out of the total number of patients presenting during the daytime and nighttime, 11 (6.4%) and 10 (7.6%) developed a postoperative complication, respectively ( = 0.697). Additionally, rates of readmission ( = 5 (2.9%) vs. = 2 (1.5%); = 0.703), redo-surgery ( = 3 (1.7%) vs. = 0; = 0.260), conversion to open surgery ( = 0 vs. = 1 (0.8%); = 0.435) and length of hospital stay ( = 3 (IQR 1, 5) vs. = 3 (IQR 2, 5); = 0.368) did not differ significantly between daytime and nighttime appendectomies. The duration of the surgery was significantly shorter in patients presenting during the day than in those presenting at night (26 min (IQR 22, 40) vs. 37 min (31, 46); < 0.001). : Different shift times did not affect the treatment outcomes or complication rates for children receiving laparoscopic appendectomy.
评估日间与夜间接受腹腔镜阑尾切除术的儿童的临床结局及并发症发生率。
本回顾性研究纳入了2020年1月1日至2022年12月31日期间因急性阑尾炎接受腹腔镜阑尾切除术的303例儿童。将患者分为两个研究组。第一组由在07:00 - 21:00日班期间接受腹腔镜阑尾切除术的患者组成(n = 171),而第二组患者在21:00 - 07:00夜班期间接受腹腔镜阑尾切除术(n = 132)。比较两组患者的基线临床和实验室数据、治疗结局及并发症情况。采用Mann-Whitney U检验比较连续变量,采用卡方检验比较分类变量。当某一单元格中的事件频率较低时,使用双侧Fisher精确检验。所有P值小于0.05被认为具有统计学意义。
两组患者中复杂性阑尾炎的比例几乎相同(n = 63,36.8% vs. n = 49,37.1%,P = 0.960)。在日间和夜间就诊的患者总数中,分别有11例(6.4%)和10例(7.6%)发生了术后并发症(P = 0.697)。此外,再入院率(n = 5(2.9%)vs. n = 2(1.5%);P = 0.703)、再次手术率(n = 3(1.7%)vs. n = 0;P = 0.260)、中转开腹手术率(n = 0 vs. n = 1(0.8%);P = 0.435)以及住院时间(n = 3(IQR 1,5)vs. n = 3(IQR 2,5);P = 0.368)在日间和夜间阑尾切除术中差异均无统计学意义。日间就诊患者的手术时间明显短于夜间就诊患者(26分钟(IQR 22,40)vs. 37分钟(31,46);P < 0.001)。
不同的轮班时间对接受腹腔镜阑尾切除术的儿童的治疗结局或并发症发生率没有影响。