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A Comparative Study of Early Versus Delayed Emergency Open Appendectomy

Abhishek G.** , Manjunath B.D.* , Abhishek G.**

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New Indian Journal of Surgery 8(1):p 29-32, January - March 2017. | DOI: https://dx.doi.org/10.21088/nijs.0976.4747.8117.5

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Abstract

 Background: The timing of operation for acute appendicitis is still a matter of controversy. This study aims to compare the outcomes between early and delayed emergency appendectomy and assess the feasibility of delayed operation. Methods: Patients who underwent emergency appendectomy at Victoria Hospital, Bengaluru between July 2015 and June 2016 were reviewed retrospectively. Outcome measures were clinical findings, white blood cell (WBC) count at the time of presentation, duration of surgery, intra-operative findings, complication rate, surgical site infection (SSI) rate, length of hospital stay and re-admission rates. Results: A total of 178 patients underwent emergency open appendectomies out of which 156 patients were included. Patients were divided into two groups based on time from onset of first symptom to incision: 73(46.7%) in group A and 83(53.2%) in group B. There were no significant differences in age, sex ratio and comorbidities between the two groups. However there was significant difference in WBC count and differential neutrophil count with Group A showing higher leukocytosis and neutrophilia. Group A showed higher intra-operative complication 32(43.83%) when compared to Group B 35(42.16%) p=0.013. There were no significant differences in wound infection, length of postoperative hospital stay and readmission rate between two groups. Conclusions: This study reveals that delayed appendectomy is safe and feasible in adults, not worsening the intra-operative or post-operative complications. The surgeon can decide the appropriate timing of appendectomy based on the available hospital resources and perform the surgery in a semi-elective manner.

 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.8117.5

Keywords

Appendicitis; Appendectomy; Emergency.

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