Cargando…

Establishing the need for clinical follow-up after emergency appendicectomy in the modern era: Retrospective case series of 145 patients

INTRODUCTION: Emergency appendicectomy (EA) is a commonly performed operation, with an increasing number of EAs being performed as day-case. The aim of this study is to establish if there is a need for post-operative follow-up and if this could prevent adverse outcomes. METHODS: A retrospective anal...

Descripción completa

Detalles Bibliográficos
Autores principales: Som, Robin, Seymour, Nicky, Thrumurthy, Sri G., Khattak, Sophia, Joshi, Shivani, Sorelli, Paolo G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125798/
https://www.ncbi.nlm.nih.gov/pubmed/30191061
http://dx.doi.org/10.1016/j.amsu.2018.08.014
_version_ 1783353221796855808
author Som, Robin
Seymour, Nicky
Thrumurthy, Sri G.
Khattak, Sophia
Joshi, Shivani
Sorelli, Paolo G.
author_facet Som, Robin
Seymour, Nicky
Thrumurthy, Sri G.
Khattak, Sophia
Joshi, Shivani
Sorelli, Paolo G.
author_sort Som, Robin
collection PubMed
description INTRODUCTION: Emergency appendicectomy (EA) is a commonly performed operation, with an increasing number of EAs being performed as day-case. The aim of this study is to establish if there is a need for post-operative follow-up and if this could prevent adverse outcomes. METHODS: A retrospective analysis of patients who underwent EA at multiple centres over a six-month period was undertaken. They were contacted by telephone and a standardised questionnaire was used to ascertain post-operative outcomes, including duration of analgesia use, duration before return to normal daily activity (ADLs), surgical site infection rates (SSI) and rates of re-presentation to medical services. Patients were stratified into those who underwent laparoscopic versus open appendicectomy, smokers versus non-smokers, and body mass index (BMI). RESULTS: A total of 145 patients were included in the study. Patients undergoing open surgery (vs. laparoscopic surgery) required analgesia for significantly longer periods, with a significantly longer return to ADLs. Smokers, when compared to non-smokers experienced a significantly longer return to work/school; and significantly higher risk of SSI and re-presenting to accident & emergency; as did patients with a BMI >30 when compared to those with a BMI <30. CONCLUSION: Most patients do not need formal outpatient assessment after EA. However, there is clearly a subset of higher risk patients who may benefit from this – patients who are smokers or obese. They have prolonged recovery times, and are at greater risk of SSI. Earlier surgical outpatient follow-up of these patients could prevent adverse outcomes.
format Online
Article
Text
id pubmed-6125798
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-61257982018-09-06 Establishing the need for clinical follow-up after emergency appendicectomy in the modern era: Retrospective case series of 145 patients Som, Robin Seymour, Nicky Thrumurthy, Sri G. Khattak, Sophia Joshi, Shivani Sorelli, Paolo G. Ann Med Surg (Lond) Original Research INTRODUCTION: Emergency appendicectomy (EA) is a commonly performed operation, with an increasing number of EAs being performed as day-case. The aim of this study is to establish if there is a need for post-operative follow-up and if this could prevent adverse outcomes. METHODS: A retrospective analysis of patients who underwent EA at multiple centres over a six-month period was undertaken. They were contacted by telephone and a standardised questionnaire was used to ascertain post-operative outcomes, including duration of analgesia use, duration before return to normal daily activity (ADLs), surgical site infection rates (SSI) and rates of re-presentation to medical services. Patients were stratified into those who underwent laparoscopic versus open appendicectomy, smokers versus non-smokers, and body mass index (BMI). RESULTS: A total of 145 patients were included in the study. Patients undergoing open surgery (vs. laparoscopic surgery) required analgesia for significantly longer periods, with a significantly longer return to ADLs. Smokers, when compared to non-smokers experienced a significantly longer return to work/school; and significantly higher risk of SSI and re-presenting to accident & emergency; as did patients with a BMI >30 when compared to those with a BMI <30. CONCLUSION: Most patients do not need formal outpatient assessment after EA. However, there is clearly a subset of higher risk patients who may benefit from this – patients who are smokers or obese. They have prolonged recovery times, and are at greater risk of SSI. Earlier surgical outpatient follow-up of these patients could prevent adverse outcomes. Elsevier 2018-08-20 /pmc/articles/PMC6125798/ /pubmed/30191061 http://dx.doi.org/10.1016/j.amsu.2018.08.014 Text en Crown Copyright © 2018 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Som, Robin
Seymour, Nicky
Thrumurthy, Sri G.
Khattak, Sophia
Joshi, Shivani
Sorelli, Paolo G.
Establishing the need for clinical follow-up after emergency appendicectomy in the modern era: Retrospective case series of 145 patients
title Establishing the need for clinical follow-up after emergency appendicectomy in the modern era: Retrospective case series of 145 patients
title_full Establishing the need for clinical follow-up after emergency appendicectomy in the modern era: Retrospective case series of 145 patients
title_fullStr Establishing the need for clinical follow-up after emergency appendicectomy in the modern era: Retrospective case series of 145 patients
title_full_unstemmed Establishing the need for clinical follow-up after emergency appendicectomy in the modern era: Retrospective case series of 145 patients
title_short Establishing the need for clinical follow-up after emergency appendicectomy in the modern era: Retrospective case series of 145 patients
title_sort establishing the need for clinical follow-up after emergency appendicectomy in the modern era: retrospective case series of 145 patients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125798/
https://www.ncbi.nlm.nih.gov/pubmed/30191061
http://dx.doi.org/10.1016/j.amsu.2018.08.014
work_keys_str_mv AT somrobin establishingtheneedforclinicalfollowupafteremergencyappendicectomyinthemoderneraretrospectivecaseseriesof145patients
AT seymournicky establishingtheneedforclinicalfollowupafteremergencyappendicectomyinthemoderneraretrospectivecaseseriesof145patients
AT thrumurthysrig establishingtheneedforclinicalfollowupafteremergencyappendicectomyinthemoderneraretrospectivecaseseriesof145patients
AT khattaksophia establishingtheneedforclinicalfollowupafteremergencyappendicectomyinthemoderneraretrospectivecaseseriesof145patients
AT joshishivani establishingtheneedforclinicalfollowupafteremergencyappendicectomyinthemoderneraretrospectivecaseseriesof145patients
AT sorellipaolog establishingtheneedforclinicalfollowupafteremergencyappendicectomyinthemoderneraretrospectivecaseseriesof145patients