Fast Track Appendectomy for Suppurative Appendicitis

Study Overview
=================
Brief Summary
-----------------
The literature has reported that fast track surgery can be safely applied to children undergoing appendectomy for acute appendicitis. There is no current evidence regarding the application of same day discharge protocol in children with intra-operative findings of suppurative appendicitis. The current standard of care for patients who present with intra-operative findings of suppurative appendicitis includes post-operative admission and treatment with intravenous antibiotics. Patients are discharged home once they have met the following discharge criteria: temperature less than 38.5 degrees Celsius, pain control with oral pain medication, and tolerating a liquid diet. Given the evidence in the literature that has shown that same day discharge of patients with acute appendicitis is safe and effective, we propose that fast track surgery protocol can be safely applied to patients with intraoperative findings of suppurative appendicitis. We hypothesize that this will result in a decreased postoperative length of stay, without an increase in 30-day complication rate.

Official Title
-----------------
Fast Track Appendectomy in Pediatric Patients With Intraoperative Findings of Suppurative Appendicitis

Conditions
-----------------
Suppurative Appendicitis

Intervention / Treatment
-----------------
* Other: Patients discharged home the same day following appendectomy


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Pediatric patients aged 5-18 Diagnosis of appendicitis and scheduled for appendectomy during the hours of 0600-1800. Intraoperative findings of suppurative appendicitis Exclusion Criteria: Pregnancy Complex medical history not appropriate for same day discharge

Ages Eligible for Study
-----------------
Minimum Age: 5 Years
Maximum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Fast track<br>Patients discharged home the same day following appendectomy | Other: Patients discharged home the same day following appendectomy<br>* Patients are discharged to home on the same day following appendectomy with oral antibiotics.<br>|
| No Intervention: Admission<br>Patients are admitted to the inpatient unit following appendectomy for suppurative appendicitis and treated per the current standard of care. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post Operative Length of Stay |  | Post anesthesia care unit arrival to discharge home, an expected average of up to 48 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Thirty Day Complication Rate | Superficial wound infection, deep organ space infection, ileus or bowel obstruction requiring hospitalization or re-operation | Thirty days | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Suppurative appendicitis, appendicitis, pediatric