Feasibility of Outpatient Appendectomy for Acute Appendicitis

PROSPECTIVE EVALUATION OF OUTPATIENT APPENDECTOMY FOR NON COMPLICATED ACUTE APPENDICITIS: Intention-to-treat Study

The aim of our monocentric prospective in intention-to-treat study is to evaluate the feasibility of outpatient appendectomy for non complicated acute appendicitis.

Acute appendicitis is one of the most common surgical emergencies and corresponds to an high number of admissions (about 120.000) in France. It mainly affects young adults and is associated to fewer complications and to a short length of stay. The notion of outpatient refers to a shorter hospital length to stay i.e. less than 12 hours without an overnight hospitalization. This notion came from 3 learned society recommendations' (SFCD, ACHBT, and AFCA) and has been considered as a national priority.

There is no consensus about appendectomy in an outpatient setting.

Inclusion Criteria:

• Non complicated acute appendicitis which has been diagnosed at physical, paraclinical and morphological examination
• Adult patient
• Patient with sufficient understanding
• Good compliance with medical prescription
• Hygiene and housing equivalent to a hospitalization
• Availability of an accompanying able to prevent the surgeon if necessary, to accompany the patient and stay at night next to him
• Less than one hour from an health care adapted to the surgical structure
• Quick access to a telephone
• Patient affiliated with social protection

Exclusion Criteria:

• complicated appendicitis
• pregnancy or breastfeeding
• unstable vital signs or fever
• objective signs of diffuse peritonitis
• ward of court or prisoners
• Discovery of a complicated shape (severe sepsis, abscess, generalized peritonitis)
• Discovery of an alternative diagnosis
• Performing an associated gesture (colectomy or typhlectomy, annexectomy...)