Day-case laparoscopic surgery for appendicitis and non-specific abdominal pain.

Laparoscopy is commonly used in the treatment of appendicular diseases and non-specific abdominal pain. Nevertheless, the role of day-case laparoscopic surgery in these cases is still debated. The aim of this study was to identify which cases of appendicitis or non-specific abdominal pain are most indicated for daycase laparoscopic surgery. From January 1 2000 to December 31 2005 at our institution 424 patients were treated laparoscopically for appendicitis or non-specific abdominal pain. 41 were operated on on a day-case basis. 81% of these (33 patients) were discharged from hospital within 24 hours of surgery. 2 patients could not be discharged because of persistent postoperative pain and 6 had a longer hospitalisation period for non-medical reasons. No major complications and no readmissions to hospital were observed in the 33 regularly discharged patients. Over the same period 61 patients were operated on by traditional "open" surgery for the same pathologies. Their postoperative hospitalisation was considerably longer. None of them were operated on on a day-case basis and none were discharged within 24 hours of surgery. 3 patients needed readmission to our institution within the first 30 postoperative days. Day-case laparoscopic. surgery is valid, safe and effective for the treatment of uncomplicated appendicitis and nonspecific abdominal pain. For successful laparoscopic day-case surgery it is of fundamental importance to ensure adequate preoperative patient selection and to pay proper attention to the treatment of postoperative pain.