| Abstract | Cilj istraživanja: Cilj ove retrospektivne studije je ispitati kliničke ishode i utvrditi stopu
komplikacija dnevne naspram noćnoj laparoskopskoj apendektomiji u djece.
Ispitanici i metode: U studiju je uključeno ukupno 303 bolesnika s dijagnozom akutnog
apendicitisa koji su bila podvrgnuti laparoskopskoj apendektomiji u periodu između 1. siječnja
2020. godine i 31. prosinca 2022. godine. Ispitanici su podijeljeni u dvije skupine. Prvu skupinu
činili su bolesnici kojima je laparoskopska apendektomija učinjena tijekom dnevne smjene od
07:00 do 21:00 (n=171), dok su bolesnici druge skupine podvrgnuti laparoskopskoj
apendektomiji u noćnoj smjeni od 21:00 do 07:00 sati (n=132). Skupine smo usporedili prema
demografskim, kliničkim i laboratorijskim podacima te ishodima liječenja i razvijenim
komplikacijama. Za usporedbu kontinuiranih varijabli korišteni su nezavisni t-test i MannWhitney U test, dok je za usporedbu kategorijskih varijabli korišten Hi-kvadrat test. Dvostrani
Fisherov egzaktni test korišten je kada je frekvencija učestalosti pojedinih varijabli bila niska.
Razina statističke značajnosti postavljena je na p<0,05.
Rezultati: Od ukupnog broja bolesnika koji su operirani tijekom dana poslijeoperacijske
komplikacije je razvilo njih 11 (6,4%), a od onih operiranih tijekom noći njih 10 (7,6%)
(p=0,697). Dodatno, stope ponovnog prijema (n=5 (2,9%) naspram n=2 (1,5%); p=0,703),
reoperacije (n=3 (1,7%) naspram n=0; p=0,260), konverzije na laparotomiju (n=0 naspram n=1
(0,8%); p=0,435) i duljina boravka u bolnici (n=3 (IQR 1, 5) naspram n=3 (IQR 2, 5); p=0,368)
nisu se značajno razlikovali između zahvata učinjenih tijekom dana naspram noću. Trajanje
kirurškog zahvata bilo je značajno kraće u bolesnika operiranih tijekom dana u odnosu na one
operirane noću (26 min (IQR 22, 40) naspram 37 min (IQR 31, 46); p<0,001).
Zaključak: Noćna laparoskopska apendektomija jednako je siguran i učinkovit zahvat poput
dnevne operacije sa sličnom stopom komplikacija i kliničkim ishodima. |
| Abstract (english) | Objectives: The aim of this study was to investigate how different shift times affect clinical
outcomes and complication rates in children who underwent laparoscopic appendectomy.
Patients and methods: From January 1st 2020 until December 31st 2022, a total of 303
pediatric patients who were diagnosed with acute appendicitis and underwent laparoscopic
appendectomy were included in the study. Patients were divided into two study groups
depending on time of day they were operated on, daytime 7:00–21:00 (Group I, n=171) versus
nighttime 21:00–7:00 (Group II, n=132). Demographic, clinical and laboratory data, as well as
clinical outcomes and complication rates were obtained for each group. The independent t-test
and Mann-Whitney U test were used for comparison of continuous variables. Chi-square test
was used to compare categorical variables, while two-sided Fisher's exact test was used if the
frequency of events was low. P value <0,05 was considered to be statistically significant.
Results: Out of 171 patients who underwent daytime appendectomy, 11 (6.4%) developed
postoperative complications, whereas the number of patients who were operated on during
nightshift and developed postoperative complications was 10 (7.6%) (p=0.697). The two groups
did not differ significantly in terms of readmission rates (n=5 (2.9%) vs. n=2 (1.5%); p=0.703)
or redo-surgery rates (n=3 (1.7%) vs. n=0; p=0.260). Conversion to laparotomy (n=0 vs. n=1
(0.8%); p=0.435) and length of hospital stay (n=3 (IQR 1, 5) vs. n=3 (IQR 2, 5); p=0.368) were
found not to be dependent of time of day. Daytime appendectomies were found to be
significantly shorter than nighttime procedures (26 min (IQR 22, 40) vs. 37 min (31, 46);
p<0.001).
Conclusion: Nighttime appendectomy is a safe procedure with favourable clinical outcomes
and similar postoperative complication rates to daytime appendectomy. |
