In the pediatric age group, appendicitis is the most common condition requiring abdominal surgery. Early appendectomy has been the treatment of choice for acute appendicitis, but delay in appendectomy can be occurred according to cirumstances
mainly due
to diagnostic appendicitis at Taegu Fatima Hospital. We compared the outcome in children with acute appendicitis who underwent appendectomy within six hours, between six and twelve hours, and after twelve hours after arrival at hospital. In
addition, we
studied whether appendectomy for midnight appendicitis can be postponed by the next morning.
Of 384 children with appendicitis, perforated appendicitis was diagnosed in 21.1% of the patients. The perforation rates according to operative delay were 17.2% in the group operated on within 6 hours(group I), 25.3% in the group oerated on 6~12
hours(group II), and 19.5% in the group operated in 12 hours(group III) after admission The difference in the rate of perforation was not significant statistically. Postoperative complications occurred in 52 patients, a frequency of 13.5% and
wound
infection was the most common one. Postoperative complications occurred in 13.8% of the patients in group I, 13.6% of the patients in group II, and in 13.0% of the patients in group III. There was no statistical differences in the rate of
complications
among the three groups. The average postoperative hospital stay were 7.16×2.65 days in group I, 7.23×2.87 days in group II. and 7.74×2.94 days in group III, which revealed no statistical difference each other. There was no deaths.
In conclusion, the incidence of perforation, and postoperative hospital stay were similar in three groups of our series. Although early appendectomy remains the treatment of choice, our results suggest that operative delay in the hospital with
appropriate management for 6~12 hours or so including overnight delay does not increase morbidity and mortality.
|