Rapid recovery vs standard care in laparoscopic appendectomy: a prospective study on patient-reported outcomes.

BACKGROUND

Laparoscopic appendectomy for uncomplicated acute appendicitis traditionally requires postoperative hospitalization. Rapid recovery and same-day discharge protocols have been increasingly adopted, yet evidence regarding patient-reported outcomes is limited. This study aimed to compare a rapid recovery program with standard postoperative care, focusing on patient satisfaction, pain experience, and postoperative functional interference with daily activities.

METHODS

In this prospective, non-randomized observational study with sequential group allocation, 96 consecutive adults undergoing laparoscopic appendectomy for uncomplicated acute appendicitis at a single tertiary hospital were enrolled. Patients were allocated sequentially into standard care (n = 62, enrolled first) or a rapid recovery program (n = 34, enrolled in a subsequent phase). Outcomes included length of hospital stay, postoperative pain intensity (NRS 0-10), pain interference with daily activities, sleep quality, and overall satisfaction, assessed via structured telephone interviews conducted 3-5 days post-discharge.

RESULTS

Baseline demographics and comorbidities were comparable between groups. Median hospital stay was significantly shorter in the rapid recovery group compared with standard care (12 vs. 18 h, p < 0.001). All patients reported high overall satisfaction with care and pain management. Patients in the rapid recovery group reported lower worst pain (p = 0.049) and least pain (p = 0.006), while median pain was slightly higher (p = 0.004). Pain outcomes showed a mixed pattern that does not support a definitive conclusion regarding superiority of pain management in either group. Sleep disturbance due to pain was less common in the rapid recovery group (18% vs. 42%, p = 0.022). Nearly all patients expressed confidence in the rapid recovery protocol and would recommend it to others.

CONCLUSION

Rapid recovery following laparoscopic appendectomy is feasible, well accepted, with high patient satisfaction and a modest reduction in hospital stay.

TRIAL REGISTRATION: ISRCTN registered.