Same Day Ambulatory Appendectomy (SAMBA)
The potential benefit of outpatient care for this common digestive emergency is considerable, both for the patients themselves and for the public health system: 1. Optimization of the care pathway, reducing the length of stay in hospital (a major issue in the context of the COVID-19 (coronavirus disease) pandemic) liberating patient beds and staff, and reducing the risk of nosocomial exposure. 2. Improved patient satisfaction compared to waiting for hours in the emergency department due to lack of hospital beds. 3. Non-inferiority of care in an outpatient unit in terms of quality and safety in day hospitalization. 4. Significant decrease in the overall cost of this pathology as a result of a reduction in the hospital stay.
• Patients aged 15-74 years
• BMI ≤ 30 kg/m2
• Uncomplicated acute appendicitis confirmed by imaging (ultrasound and/or CT and/or MRI)
‣ Temperature ≤ 38,1°C and \> 35,5°C
⁃ Appendix diameter \> 6mm and ≤ 15mm
⁃ Without effusion or with only localized peri-appendicular effusion
⁃ Infiltration of peri-appendicular fat without abscess or plastron
⁃ No sign of perforation
⁃ Leukocytes ≤ 15,000G/L AND
⁃ CRP (C reactive protein) ≤ 50mg/L
• If pain, calmed by level 2 analgesic at maximum
• Ambulatory criteria
‣ Availability of monitoring by a relative during the 12 hours after discharge from the hospital
⁃ Residence located less than 20 minutes by car from a health center (hospital or clinic)
⁃ Access to a telephone mobile or fixed in case of problems
• Signature of the written informed consent form by the patient
• If the patient is a minor, signature of the written informed consent form by both parents or their legal representative
• Affiliation to a French health insurance scheme or equivalent