FTP6.11 The Quality of Service of Emergency Appendicectomy in Children in a Rural General Hospital between 2013 and 2022
Samy Mohamed, Mailen Sganga, Francesca Saleh, Stanley Lee, Mohamed Unais, Kausik Khan- Surgery
Abstract
Aims
To evaluate our service of emergency appendectomy for children (3-16 years) against the quality indicators identified by the Association of Surgeons of Great Britain and Ireland commissioning guidelines and the British Association of Paediatric Surgeons. This study was carried out between January 2013 and September 2022. We evaluated 5 main qualities; time to surgery, operative techniques (laparoscopic, open), length of stay (LOS), 30 days post-operative re-admission rate, and the rate of “negative” appendicectomy.
Methods
A retrospective analysis was conducted. Patients were identified from the hospital database. Data including demographics, above qualities and histology were collected from the hospital clinical information system “Myrddin” and Welsh Clinical Portal.
Results
Total number of children who had emergency appendicectomy over this 10 years period of time was 194, age range between 3-16 years old, 87 females, and 107 males. Mean time from admission to surgery was 12.8 hours. Total in-hospital stay was 2.7 days. There has been an increase in rate of laparoscopic appendectomy from 17.4% in 2013 to 84.6% in 2021. Total laparoscopic appendicectomy was performed in 40.2% of this cohort (7-16 years old) without conversion. Negative appendicectomy was 14.9%. Re-admission rate was 4.6% and it was mainly due to wound infection.
Conclusions
These results showed that these children are accurately diagnosed and treated in a timely manner according to the published guidelines & recommendation. Laparoscopic technique is increasingly used safely in appropriate cases.