Mohammed Amir, M H Raja.
Timings for Surgery of Acute Appendicitis.
J Coll Physicians Surg Pak Jan ;10(8):295-7.

Early appendectomy is traditionally considered the treatment of choice for acute appendicitis. Recently many reports have shown that postponing surgery overnight for such cases till the following morning is safe without increase in the rate of complications. In our hospital, too, it has been our practice for those patients admitted with non-complicated acute appendicitis who come in the evening or night to delay their surgery till the following day. A retrospective study was undertaken to see the impact of this policy on s the rate of complicated cases, postoperative complications and hospital stay. It included 270 patients under going surgery for acute appendicitis from January, 1995 through December 1999. The patients were grouped into two categories; Group A included (84) cases who were operated within 6 hours of admission and GroupB comprised the rest (186) who were operated after 6 hours. In Group A, 85.7% cases had acute uncomplicated appendicitis, 9.5% complicated (perforated and gangrenous) and 4.76% had normal appendices. In Group B, there were 83.87% cases of acute appendicitis, 8.6% complicated and 6.45°/a normal appendices. In Group A 13.1% cases had postoperative complications as against 5.09% in Group B. The mean hospital stay, too, was comparable in both the groups (4.16 days in Group A and 4.8 days in Group B). The data suggests that elective overnight delay in appendectomy is safe without any increase in the rate of complications, postoperative morbidity and hospital stay.

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