Annals of Coloproctology

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Risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis: Jiyoung Shin, Myong Hoon Ihn, Kyung Sik Kim, Sang Hyun Kim, Jihyoun Lee, Sangchul Yun, Sung Woo Cho; Ann Coloproctol. 2023;39(1):50-58. Published online November 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00773.0110

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Purpose
We sought to identify the risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis.
Methods
The study retrospectively analyzed 497 patients who underwent laparoscopic appendectomies for uncomplicated appendicitis between January 2018 and December 2020. The patients were divided into an early discharge group (≤2 days) and a late discharge group (>2 days) based on the length of hospital stay (LOS). The patients were also divided into uneventful and complicated groups according to the need for additional treatment after standard follow-up.
Results
Thirty-seven patients (7.4%) were included in the late discharge group. The mean LOS of the late discharge groups was 3.9 days. There were significant differences according to age, preoperative C-reactive protein (CRP), and operative time between the 2 groups. Only operative time was significantly associated with prolonged LOS in multivariate analysis. Thirty-five patients (7.0%) were included in the complicated group. The mean duration of treatment in the uneventful and complicated groups was 7.4 and 25.3 days, respectively. Significant differences existed between the uneventful and complicated groups in preoperative body temperature, preoperative CRP levels, maximal appendix diameter, and the presence of appendicoliths. In multivariate analysis, preoperative CRP levels and maximal appendix diameter were independent predictors of delayed treatment completion.
Conclusion
Shorter operative time is desirable to ensure minimal hospital stay in patients with uncomplicated appendicitis. Further efforts are needed to ensure that patients with uncomplicated appendicitis do not experience delayed treatment completion after laparoscopic appendectomies.

Citations

Citations to this article as recorded by

Safety and Efficacy of Same‐Day Discharge After Laparoscopic Appendicectomy: An Australian First Prospective Cohort Study
Prithvi Santana, Odette Pheiffer, Wing Yin Lau, Eoghan Blount, Megan Courtney, Edward Tong, Selwyn Selvendran, Neil Merrett, Devesh Kaushal
ANZ Journal of Surgery.2026;[Epub] CrossRef
Association between preoperative neutrophil-to-lymphocyte ratio and length of stay in pediatric patients undergoing laparoscopic appendectomy: a retrospective cohort study
Ming Liu, Yunpeng Gou, Ping Yang
BMC Pediatrics.2025;[Epub] CrossRef
Comparative Outcomes of Immediate and Delayed Wound Closure Techniques in Appendectomies for Gangrenous Appendicitis
Anzar Usman, Esha Akbar, Aliha Mukhtar, Iqra Nasir, Usama Rehman, Adil Iqbal, Muhammad Umar Umar
DEVELOPMENTAL MEDICO-LIFE-SCIENCES.2024; 1(3): 18. CrossRef
Non-linear association between C-reactive protein levels and length of stay in pediatric appendicitis patients undergoing laparoscopic appendectomy
Ming Liu, Ping Yang, Yunpeng Gou
Frontiers in Pediatrics.2024;[Epub] CrossRef
Nomogram prediction model for length of hospital stay following laparoscopic appendectomy in pediatric patients: a retrospective study
Ming Liu, Ping Yang, Yunpeng Gou, Qiang Chen, Dong Xu
Frontiers in Pediatrics.2024;[Epub] CrossRef

Laparoscopic Versus Open Appendectomy for Appendicitis in Elderly Patients: Hyun Nam Baek, Yong Hwan Jung, Yong Hee Hwang; J Korean Soc Coloproctol. 2011;27(5):241-245. Published online October 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.5.241

7,798 View
57 Download
13 Citations

Abstract PDF

Purpose

The appendectomy is the most common emergent surgical procedure in elderly patients. The increasing number of elderly persons has been accompanied by an increase in the number of cases of acute appendicitis in the elderly. In order to understand the clinical significance of a laparoscopic appendectomy for elderly patients with appendicitis, we investigated the results of a laparoscopic appendectomy for treating patients over 60 years of age with appendicitis and compared them with the results for an open technique.

Methods

We studied retrospectively patients over 60 years of age who underwent an appendectomy with either a laparoscopic (LA) or open (OA) technique for appendicitis between July 2007 and December 2009. There were 30 patients in the LA group and 47 patients in the OA group. The demographic data, operative time, length of the hospital stay, bowel movement, pain control, cost, complications and pre-existing disease were assessed.

Results

There were no significant differences between the LA and the OA groups with respect to pre-existing diseases, gender, age, American Society of Anesthesiologists (ASA) score and the number of cases of complicated appendicitis, operative time, length of hospital stay, and times of analgesics use. However, the proportion of early gas out (within POD #2) was significantly greater in the LA group (80% vs. 57%, P < 0.05), and postoperative complications were significantly lower in the LA group (7% vs. 32%, P < 0.01). The costs for the two groups were not significantly different.

Conclusion

A laparoscopic appendectomy is a safe and effective procedure in elderly patients and is not associated with any increase in morbidity. It can be recommended for routine use in treating elderly patients with appendicitis.

Citations

Citations to this article as recorded by

Therapeutic effectiveness and influencing factors of laparoscopic appendectomy with mesoappendix dissection in the treatment of acute appendicitis
Jiang Yuan, Qiang Liu, Bo-Yu Wu
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
EAES/SAGES evidence-based recommendations and expert consensus on optimization of perioperative care in older adults
Deborah S. Keller, Nathan Curtis, Holly Ann Burt, Carlo Alberto Ammirati, Amelia T. Collings, Hiram C. Polk, Francesco Maria Carrano, Stavros A. Antoniou, Nader Hanna, Laure-Meline Piotet, Sarah Hill, Anne C. M. Cuijpers, Patricia Tejedor, Marco Milone, E
Surgical Endoscopy.2024; 38(8): 4104. CrossRef
Laparoscopic and robotic surgery for colorectal cancer in older patients: a systematic review and meta-analysis
Carlo Alberto Ammirati, Roberto Passera, Elsa Beltrami, Chiara Peluso, Nader Francis, Alberto Arezzo
Minimally Invasive Therapy & Allied Technologies.2024; 33(5): 253. CrossRef
The Role of Basic Laboratory Parameters in Diagnosing Acute Appendicitis and Determining Disease Severity in the Elderly
Mustafa Yeni, Rıfat Peksöz
Turkish Journal of Colorectal Disease.2022; 32(2): 110. CrossRef
Comparison of Postoperative Acute Kidney Injury Between Laparoscopic and Laparotomy Procedures in Elderly Patients Undergoing Colorectal Surgery
Shun Huang, Zheng Li, Nan Zou, Ting Dai, Xiang Long Cao, Zhe Jia, Wen Ping Peng, Ning Yang, Rui Fang Jia, Ming Zhang Zuo
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2021; 31(2): 160. CrossRef
GERİATRİK AKUT APANDİSİTLERİN TANI VE TEDAVİSİNDEKİ FARKLILIKLAR: TEK MERKEZ DENEYİMİ
Ahmet TÜRKAN, Ahmet ERDOĞAN, Uğur KILINÇ
Kırıkkale Üniversitesi Tıp Fakültesi Dergisi.2021; 23(1): 1. CrossRef
Acute Appendicitis in the Elderly: A Literature Review on an Increasingly Frequent Surgical Problem
Sintija Lapsa, Arturs Ozolins, Ilze Strumfa, Janis Gardovskis
Geriatrics.2021; 6(3): 93. CrossRef
Perforated vs. nonperforated acute appendicitis: evaluation of short-term surgical outcomes in an elderly population
Fabio Rondelli, Michele De Rosa, Paolo Stella, Marcello Boni, Graziano Ceccarelli, Ruben Balzarotti, Andrea Polistena, Alessandro Sanguinetti, Walter Bugiantella, Nicola Avenia
Minerva Chirurgica.2019;[Epub] CrossRef
Outcomes of appendectomy in elderly veteran patients
Oswaldo Renteria, Zain Shahid, Sergio Huerta
Surgery.2018; 164(3): 460. CrossRef
Independent Preoperative Predictors of Prolonged Length of Stay after Laparoscopic Appendectomy in Patients over 30 Years of Age: Experience from a Single Institution
Eric S. Wise, Stephen P. Gadomski, Annette M. Ilg, Camilo Bermudez, Emily W. Chan, Michelle L. Izmaylov, Samantha J. Gridley, Jessica V. Kaczmarek, Norman T. Melancon, Sarwat Ahmad, Kyle M. Hocking, Jose J. Diaz, Stephen M. Kavic
The American Surgeon™.2016; 82(11): 1092. CrossRef
Conventional Laparoscopic Appendicectomy and Laparoscope-Assisted Appendicectomy: a Comparative Study
Mayank Baid, Manoranjan Kar, Utpal De, Mrityunjay Mukhopadhyay
Indian Journal of Surgery.2015; 77(S2): 330. CrossRef
Acute appendicitis: position paper, WSES, 2013
Ferdinando Agresta, Luca Ansaloni, Fausto Catena, Luca Andrea Verza, Daniela Prando
World Journal of Emergency Surgery.2014;[Epub] CrossRef
Thirty-day outcomes of laparoscopic versus open appendectomy in elderly using ACS/NSQIP database
Ashkan Moazzez, Rodney J. Mason, Namir Katkhouda
Surgical Endoscopy.2013; 27(4): 1061. CrossRef

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