Appendicitis Acute Clinical Trial
Official title:
Evaluation of the Ambulatory Feasibility of Appendicectomy for Acute Appendicitis in Children 6 to 17 Years
The investigators will conduct a monocentric prospective preliminary study evaluating the feasibility of appendectomy for simple acute appendicitis in a cohort of 6-17 year-old children presenting to the emergency department of the Hôpital Pédiatrique de Nice CHU-Lenval (Lenval Childre Hospital, Nice) on a Period of 1 year.
Acute appendicitis represents the first visceral surgical emergency of the child in terms of
frequency, resulting in hospitalization, hospitalization and family costs, as well as an
alteration in family dynamics.
Reducing the duration of hospitalization and allowing the child to return more quickly to his
usual environment would not only reduce the risks of nosocomial infections and the workload
of medical and paramedical teams but would reduce the emotional burden for the child, In
addition to its consequences in terms of professional disorganization induced in the parents
by the hospitalization of their child. Ambulatory hospitalization would also reduce the cost
of this pathology.
In the context of ambulatory surgery, the patient's journey from admission to hospital must
be perfectly codified; The novelty of this study lies in the fact of applying this mode of
hospitalization to emergency surgery.
Once the consultation for abdominal pain by an emergency pediatrician carried out, the
diagnostic orientation is confirmed by a visceral pediatric surgeon who performs a biological
check-up and an abdominal ultrasound. After confirmation of eligibility for ambulatory care
according to national recommendations and informed consent, the child is - according to the
time of care and the clinical condition of the patient - immediately hospitalized in the unit
(UCA) be allowed to return to his home with reconviction in the ambulatory surgery unit the
next morning, at the opening of the service, on an empty stomach.
The abdominal ultrasound confirms the orientation and the diagnosis of acute appendicitis
simple is posed.
The laparoscopic appendectomy is performed after the anesthesia consultation. The patient is
monitored and replenished early in the UCA according to a standardized and computerized
protocol.
The return home is authorized by the confirmation of "aptitude to the street" by systematic
consultation of a senior surgeon and an anesthetist.
The surgical and anesthetic techniques remain the same as in traditional surgery, but the
timing is organized for an outpatient treatment The follow-up of the child will be carried
out as early as day 1 by the call of the UCA, then at day 8 during postoperative consultation
and finally at day 30 post-operative per call.
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