Since appendicitis is more likely to involve young subjects and leads to few complications, all the conditions are met for ambulatory care.
With about 80,000 interventions each year in France, the appendicitis operation (appendectomy) is considered frequent. "She is also very emotionally invested by digestive surgeons, whatever their age, because this is often the first operation they have carried out during their training," notes Professor Catherine Arvieux (CHU Grenoble-Alpes), professor of digestive surgery and responsible for teaching at the college of general visceral and digestive surgery.
This year she presented the report of the congress of the French Association of Surgery (AFC) on this subject. "There are no more complications with a young surgeon, but the time for surgery is a little longer," she says. At the moment, the procedure is rarely performed on an outpatient basis with only 1,139 of the 77,472 appendectomies performed in 2015, which is not surprising for an emergency procedure. But Pr Arvieux is optimistic: "I think we could manage to make between 30% and 50% of ambulatory operations," she confided to the Figaro.
This is also the opinion of Dr. Thevy Hor (Paris) who writes in the report of the congress (Surgery ambulatory general and digestive, Editions Arnette): the appendectomy "is carried out in young, socialized, healthy subjects. It is a short-term intervention with low risks. Thus all the conditions are met for an ambulatory care ".
"It's true that the complication rate, around 6%, is extremely low for emergency surgery," confirms Professor Arvieux. "The obsession of the surgeon," she adds, "is the laparoscopic or anesthetic accident, fortunately very rare. For complications, it is generally a scar or deep abscess infection, and deaths are exceptional and concern patients in poor health for other reasons. "
Appendicitis concerns young subjects: three-quarters of those undergoing surgery are younger than 33 years of age. France has also been one of the countries where the most appendectomies were made. "In 1999, 20 appendectomies per 10,000 inhabitants were carried out in France," says Arvieux, "against, for example, 15 per 100,000 in Sweden. But there was no reason to have more appendicitis in France than in Sweden! Doubtless, it was true, was an excess. Ten years later, the rate was only 14 per 100,000 in France, close to Sweden, 12 per 100,000. And now we have returned to the level of other European countries. "
"The result is that in the past it was possible to remove up to 20% of appendages by excess, whereas they were finally normal and even have complications for unnecessary surgery", explains to the Figaro Professor Denis Collet, president of the AFC. "Today, 97% of patients who undergo surgery have had previous imaging tests, either an ultrasound or a CT scan, or both, and there are fewer than 5% of normal appendages, he. "For appendicitis that appears simple, ambulatory surgery would be possible, subject to an adapted and reactive organization, because let us not forget that this is an emergency intervention," explains Professor Arvieux, but for others, hospitalization will remain the key. "