Should kids be sent home right after appendectomy?

Reuters, Saturday 26 May 2012

A study looks at whether it's ok to send children home after an appendectomy, weighing the pros and cons

Researchers at Miami Children's Hospital tested the theory on more than 200 pediatric appendectomy cases, and the kids who went home after surgery had about the same rates of complications and readmissions as the kids who stayed in the hospital overnight. Most parents didn't seem to mind the same-day discharge.

The researchers say the shortened hospital stay reduces the kids' stress related to being away from home, and it may cut the risk of a hospital-acquired infection as well as trimming costs.

If it's possible, sending kids home the same day as their surgery "is a great trend," said Dr. Henry Rice, chief of pediatric general surgery at the Duke University Medical Center in Durham, North Carolina.

For the new study, researchers led by Dr Cathy Burnweit followed all the kids between ages two and 19 who had their appendix removed at Miami Children's between July 2010 and April 2011.

Appendectomies are typically needed when the appendix becomes inflamed and painful, usually because of an infection. It is the most common emergency abdominal surgery performed in the US.

Of 251 kids and teens admitted for appendectomy, doctors considered 207 eligible to go home the same day as their surgery. Another 44 children had more severe problems that required longer hospitalisation.

Most of the kids' appendixes were removed laparoscopically -- using a small scope inserted through the patients' bellybuttons.

Of the 207 kids eligible to go home, 162 did, and 45 were admitted to the hospital overnight because it was too late to be discharged, the family couldn't arrange transportation, they didn't want to be sent home the same day or they were vomiting or had pain.

Overall, no patient in the study experienced a major complication.

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