One-day appendectomy: more an opportunity than a challenge. A prospective protocol.

IF 1.3 4区医学 Q2 SURGERY

Minerva Surgery Pub Date : 2026-02-01 DOI:10.23736/S2724-5691.25.11021-6

Davina Perini, Jacopo Martellucci, Maximilian Scheiterle, Francesca Cammelli, Annamaria DI Bella, Salvatore DE Masi, Alessandro Bruscino, Paolo Prosperi

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Abstract

Background: Short-stay and ambulatory pathways for laparoscopic appendectomy (LA) have gained increasing acceptance, yet conventional hospitalization remains common practice for acute appendicitis (AA). This study aimed to evaluate the safety and feasibility of a structured one-day LA protocol (discharge within 24 hours) and to refine patient selection criteria.

Methods: A two-phase observational study was conducted, including a retrospective analysis followed by prospective validation of predefined eligibility criteria for one-day discharge.

Results: Among 812 LA patients, early discharge was achieved safely without increased complications or readmissions. In the prospective phase, 132 patients met criteria and 90 were discharged within 24 hours. Logistic regression confirmed operator-dependent factors - especially drainage and longer operative time - as primary barriers to protocol adherence.

Conclusions: A structured one-day LA protocol is safe, feasible, and effective in selected patients. The one-day pathway is now standard of care for uncomplicated AA at our institution.

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一天阑尾切除术：与其说是挑战，不如说是机遇。前瞻性协议。

背景：腹腔镜阑尾切除术（LA）的短期住院和门诊路径已经越来越被接受，然而传统的住院治疗仍然是急性阑尾炎（AA）的常见做法。本研究旨在评估结构化一天LA方案（24小时内出院）的安全性和可行性，并完善患者选择标准。方法：进行了一项两期观察性研究，包括回顾性分析，然后对预定的一天出院资格标准进行前瞻性验证。结果：在812例LA患者中，早期出院安全，无并发症增加或再入院。在前瞻性阶段，132名患者符合标准，90名患者在24小时内出院。Logistic回归证实了操作者相关因素——尤其是引流和较长的手术时间——是协议遵守的主要障碍。结论：结构化的1天LA方案在选定的患者中是安全、可行和有效的。一天的途径现在是我们机构简单的AA的标准护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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