Abstract

Objective: Recent studies have focused on approaches based on clinical parameters rather than predetermined therapy. The clinical outcomes based on setting of protocols are limited. In 2020, our institutional protocol was revised to standardize management of appendicitis. We aim to present the clinical outcomes of setting standardization in the management of appendicitis.

Methods: A retrospective study was conducted in patients who were diagnosed with appendicitis and underwent appendectomy according to the settled preoperative, operative and postoperative standards, between April 2020 and October 2020. The results of the same number of patients treated before standardization (Pre-S) and those treated after standardization (Post-S) were compared.

Results: 17 patients (mean age - 7 years) underwent surgery. Early recurrence occurred in one patient. There was no prolonged constipation, bladder dysfunction or mesh related complications.

Results: The data of 388 patients were analyzed, 13/188 (7%) patients in the Pre-S group and 5/188 (3%) in the Post-S group were found to have negative laparotomy and were excluded from the groups. There was no difference between the groups in terms of demographic, clinical and operative characteristics (p>.05). It was found that the length of hospital stay decreased in Posy-S patients, but the difference was not significant (p>0.05). In cases with perforated appendicitis, a significant decrease was found in the Post-S group in terms of total number of complications and re-admission to the hospital (p<0.05).

Conclusion: It was concluded that setting standards in the approach to appendicitis in children improve clinical outcomes, especially in patients with perforated appendicitis. Children with appendicitis managed with standard protocols may benefit more from treatments. We recommend the development and implementation of standards in terms of fewer negative laparotomies, fewer complications, and fewer re-admissions.

Cite as: Ozcakir E, Okay ST, Kaya K. Outcomes of Setting Standards in The Management of Children With Appendicitis. Coc Cer Derg/Turkish J Ped Surg 2022; 36(1): 35-42 doi: 10.29228/JTAPS.54907