Current or Delayed Appendectomy? Effect of Time on 170 Patients with Acute Appendicitis

A Prospective Randomized Study

Abstract

Surgeons throughout the world deal with acute appendicitis more than any other emergency medical illness. An estimated 6-7% of the population will experience acute appendicitis at some point in their lives. Acute appendicitis affects over 7% of the population at some point, with the highest prevalence seen in those aged 10–30. Because of the potential for acute appendicitis to proceed pathologically into perforation, gangrenous appendicitis, and abscess formation, it is normal practice to perform appendicectomy as soon as possible, if not immediately. Nevertheless, there have been authors who have questioned this approach and proposed that appendicectomies can be postponed in certain instances without causing any negative postoperative complications. One hundred and seventy individuals (94 men and 76 females) had appendicectomy in a hospital in the Diyala governorate between June 2021 and July 2022 as part of this prospective randomized trial. All of the patients who underwent appendectomy were divided into two groups for the purpose of performing the comparison: Patients who undergo surgery within eight hours after reaching the hospital are categorized as Group A, whereas patients who undergo surgery after eight hours are categorized as Group B. Results Group B had a lower mean white blood cell count on the first day after surgery compared to group A (p = 0.0018). This could be because both groups' patients took antibiotics, typically a combination of two drugs (one cephalosporin plus metronidazole) before the operation. The timing of commencing the liquid diet did not differ significantly between the two groups. Both groups began oral medication within the first 24 hours (p value 0.0715). Group B had a rate of 0.37% for acute and early postoperative complications, while group A had a rate of 0.02%. It is not statistically significant (p = 0.4022). Group A's postoperative hospital stay durations range from two days to less than one day, whereas group B's durations are similarly non-significant (p value 0.0826).Readmission for serious surgical site infection (severe cellulitis or wound abscess) or developing symptoms of adhesional intestinal obstruction occurred in 0.025% of patients in group B and 0.016% of patients in group A within 30 days (p value 0.9984). If the P-value is more than 0.05, then it is not statistically significant. Acute appendicitis is still a surgical emergency, although simple instances aren't always considered life-threatening enough to warrant an immediate operation (early appendicectomy) due to concerns about potential complications. Results showed that individuals with simple appendicitis might safely undergo delayed appendicectomy. A delayed appendicectomy has several potential benefits, including better patient care, more effective use of medical resources, and the ability to devote operating rooms to other potentially life-threatening emergencies.