Yetişkin hastalarda gece veya gündüz yapılan laparoskopik apendektomilerin klinik sonuçlarının irdelenmesi

Abstract

Amaç: Akut apandisit en sık görülen cerrahi acil durumlardan biridir ve laparoskopik apendektomi günün her saatinde sıklıkla uygulanmaktadır. Bu çalışmanın amacı, laparoskopik apendektomi sonrası perioperatif ve postoperatif sonuçlar üzerinde ameliyat zamanlamasının etkisini değerlendirmektir. 
Gereç ve yöntem: Bu retrospektif çalışmaya, Ocak 2023 ile Aralık 2024 tarihleri arasında Pamukkale Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı'nda akut apandisit nedeniyle laparoskopik apendektomi geçiren hastalar dahil edilmiştir. Hastalar, ameliyat saatine göre gündüz grubu (08:00–20:00) ve gece grubu (20:00–08:00) olarak sınıflandırılmıştır. Demografik özellikler, semptom süresi, ameliyat süresi, konversiyon oranı, dren kullanımı, morbidite, mortalite, yeniden yatış ve hastanede kalış süresi analiz edilmiştir.
Bulgular: Çalışmaya toplam 114 hasta dahil edildi; bunların 62’si (%54,4) kadın, 52’si (%45,6) erkekti. 67 hastada (%58,8) gündüz ameliyatı yapılırken, 47 hastada (%41,2) gece ameliyatı gerçekleştirildi. Hasta özellikleri gruplar arasında benzerdi. Semptomların başlamasından hastaneye yatışa kadar geçen süre gündüz ve gece grupları arasında benzerdi (1,85’e karşı 1,91 gün, p=0,829). Ortalama ameliyat süresi gündüz grubunda 64,5±14,3 dakika, gece grubunda ise 59,6±17,7 dakikaydı (p=0,106). Gece grubunda iki hastada (%4,3) açık cerrahiye geçiş görülürken, gündüz grubunda hiç görülmedi (p=0,168). Dren yerleştirme, postoperatif morbidite, hastanede kalış süresi, yeniden yatış veya mortalite açısından anlamlı bir fark gözlenmedi.
Sonuç: Gece saatlerinde gerçekleştirilen laparoskopik apendektomi, gündüz yapılan cerrahi kadar güvenli ve etkili olup benzer perioperatif ve postoperatif sonuçlar sağlamaktadır.

Keywords

• Yetişkin
• akut apandisit
• laparoskopik apendektomi
• gündüz cerrahisi
• gece cerrahisi

Evaluation of clinical outcomes of laparoscopic appendectomies performed during daytime or nighttime in adult patients

Abstract

Purpose: Acute appendicitis is one of the most common surgical emergencies, and laparoscopic appendectomy is frequently performed at any time of day. The aim of this study was to evaluate the effect of operation timing on perioperative and postoperative outcomes following laparoscopic appendectomy. 
Materials and methods: This retrospective study included patients who underwent laparoscopic appendectomy for acute appendicitis at the Department of General Surgery, Pamukkale University Faculty of Medicine, between January 2023 and December 2024. Patients were classified into a daytime group (08:00–20:00) and a nighttime group (20:00–08:00) according to the timing of surgery. Demographic characteristics, symptom duration, operative time, conversion rate, drain usage, morbidity, mortality, readmission, and length of hospital stay were analyzed.
Results: A total of 114 patients were included, of whom 62 (54.4%) were female and 52 (45.6%) were male. Daytime surgery was performed in 67 patients (58.8%), whereas 47 patients (41.2%) underwent nighttime surgery. Patient characteristics were comparable between groups. The interval from symptom onset to hospital admission was similar between the daytime and nighttime groups (1.85 vs. 1.91 days, p=0.829). Mean operative time was 64.5±14.3 minutes in the daytime group and 59.6±17.7 minutes in the nighttime group (p=0.106). Conversion to open surgery occurred in two patients (4.3%) in the nighttime group and none in the daytime group (p=0.168). No significant differences were observed regarding drain placement, postoperative morbidity, length of hospital stay, readmission, or mortality.
Conclusion: Nighttime laparoscopic appendectomy is as safe and effective as daytime surgery, with comparable perioperative and postoperative outcomes.

Keywords

• Adult
• acute appendicitis
• laparoscopic appendectomy
• daytime surgery
• nighttime surgery

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