Appendectomies are the most popular surgeries in the world these days. However, often people feel it is a state of emergency and need immediate surgery once a complication is detected. As reported in the September issue of JAMA journal, Archives of Surgery, postponing one’s surgical procedure by twelve hours or more does not affect success rates after a 30 day period.
Angela M. Ingraham, M.D., M.S., of the American College of Surgeons (ACS), Chicago and associates state:
Appendectomy is the most common emergent surgical procedure performed worldwide, with appendicitis accounting for approximately 1 million hospital days annually. Time from onset of symptoms to operative intervention is associated with more advanced disease. Recent developments in imaging and antibiosis have afforded improved preoperative assessment and treatment, allowing for non-operative management of abscesses and phlegmons [diffuse inflammation of the soft or connective tissue due to infection] and potentially limiting the need for immediate operative intervention to halt disease progression.
Hospitals participating in the ACS National Surgical Quality Improvement Program, and had patients undergo acute appendicitis surgery, submitted data to Ingraham for analysis. Information from 32,782 persons that had an appendectomy between 2005 and 2008 was utilized. Seventy five percent had the preventative surgery within six hours of arriving to the hospital. Fifteen percent had the surgery between six and 12 hours, and finally, ten percent waited more than 12 hours after admission into the facility to reach the operating room.
Thirty days passed, and between the three groups there were no reports of complications or fatalities. It is a fact that the longer one waited to be operated on, the longer the actual procedure took and recovery time was lengthened, but this had no relevance on the final outcomes and after effects of the operation.
The research group doctors state:
Because of the growing issues surrounding access to emergency care and specialist coverage, care for emergency general surgery patients is increasingly the responsibility of acute care surgeons and specialized services, which cover the specialties of trauma, emergency general surgery and critical care.
As hospital traffic increases year to year, these delays in surgeries will become more common. As long as there are no increased complications, this is an acceptable action.
In conclusion:
As the elderly population continues to increase, the medical needs of patients presenting for emergency general surgical care will become increasingly complex and will demand additional resources and attention. Because of potentially limited physical and professional staffing resources, an acute care surgeon may need to delay the operation of less critically ill patients to appropriately care for those requiring immediate attention.
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Written by: Sy Kraft, B.A. – Journalism – California State University, Northridge (CSUN)