Application of enhanced recovery after surgery in ambulatory laparoscopic appendectomy

Objective To assess the safety and feasibility of ambulatory laparoscopic appendectomy (ALA) with the concept of enhanced recovery after surgery (ERAS). Methods The clinical data of patients with appendicitis undergoing surgical treatment in the First Affiliated Hospital of Xinjiang Medical University from August 2017 to August 2018 were retrospectively analyzed. Among 196 patients, 100 cases received ambulatory laparoscopic appendectomy with ERAS (ERAS group) and 96 cases received conventional laparoscopic appendectomy (control group). The average length of hospital stay, hospitalization expenses, NRS pain score at 6 h, 12 h, 24 h after surgery, patient satisfaction, time of postoperative off-bed activity, time of gastrointestinal function recovery, and postoperative complications were compared between two groups. Results There were significant differences in average length of hospital stay [(36.5±1.3) h vs. (74.5±4.4) h, t=80.986) , hospitalization expenses[ (9 617.5±637.5) Yuan vs. (13 740.1±640.6) Yuan, t=45.150], 6 h NRS pain score[ (3.4±1.4) vs. (4.1±1.3) , t=3.360],12 h NRS pain score (2.0±1.3 vs. 2.5±1.1, t=-2.929) , time of postoperative off-bed activity[ (5.7±0.9) h vs. (11.5±2.0) h, t=26.237], time of gastrointestinal function recovery (6.8±1.1) h vs. (12.2±2.3) h, t=20.341]and patient satisfaction [ (95.6±3.0) vs. (90.5±4.9) , t=-8.644]between ERAS group and control group (all P 0.05) . Conclusion The ambulatory laparoscopic appendectomy with enhanced recovery after surgery is safe and feasible, with the advantages of low hospitalization cost, short hospitalization time, and high patient satisfaction. Key words: Appendectomy; Day care; Enhanced recovery after surgery