MedPath

Feasibility of Outpatient Appendectomy for Acute Appendicitis

Phase 3
Completed
Conditions
Acute Appendicitis
Interventions
Procedure: outpatient surgery
Registration Number
NCT01839435
Lead Sponsor
Centre Hospitalier Universitaire, Amiens
Brief Summary

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

Detailed Description

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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
120
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...)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
outpatient patientsoutpatient surgeryOutpatient surgery will be proposed to all patients
Primary Outcome Measures
NameTimeMethod
success of outpatient appendectomypostoperative day 30

The primary endpoint corresponds to the proportion of outpatient appendectomy defined as the number of patients whose hospital length of stay is less than 12 hours.

This endpoint will be evaluated during the consult 30 day after the surgery

Secondary Outcome Measures
NameTimeMethod
the reoperation ratepostoperative day 30

the reoperation rate reflects the proportion of patients who are operated on after their post-outpatient surgery discharge

The proportion of deprogrammingpostoperative day 30

The proportion of deprogramming defined as the number of reconvened patients who do not return the next day

post-surgical painthe day of the surgery prior to the discharge

the post-surgical pain is evaluated thanks to the Brief Pain Inventory Form

The hospital readmission ratepostoperative day 30

The hospital readmission rate is defined as the number of patients who are discharged from hospital after outpatient surgery but are subsequently readmitted

The unexpected consultation ratepostoperative day 30

The unexpected consultation rate reflects the number of AS patients attending the emergency department for a postoperative problem.

post-surgical quality of lifethe day of the surgery prior to the discharge

the post-surgical quality of life is evaluated thanks to the SF36 Form

The unplanned overnight admission ratepostoperative day 30

the proportion of patients who are discharged more than 12 hours after the surgery and are thus hospitalized for at least one night

Trial Locations

Locations (1)

Amiens University Hospital

🇫🇷

Amiens, France

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