Outcomes of laparoscopic appendectomy during the level 3 alert of the coronavirus disease 2019 pandemic in Taiwan: Experience in a referral center

Background: Emerging studies have reported an increased proportion of complicated cases of acute appendicitis and increased prehospital delay during the coronavirus disease 2019 (COVID-19) pandemic. We wondered whether there was a difference in the perioperative outcomes of laparoscopic appendectomy during the 69-day level 3 alert in our community. Materials and Methods: Adult patients who underwent laparoscopic appendectomy for acute appendicitis between May 19 and July 26, during the years of 2019, 2020, and 2021 at our institution, were included. Patient demographics, clinical presentation, interval from emergency department (ED) arrival to operation, operation duration, hospital stay, and postoperative complications were analyzed using SPSS Statistics. The Kruskal-Wallis and Pearson Chi-square tests were used for the analysis of numerical and nominal variables, respectively. Results: A total of 94, 102, and 63 cases were included during the corresponding periods in 2019, 2020, and 2021, respectively. Patient age, sex, symptom duration at presentation, percentage of leukocytosis, bacteremia, complicated appendicitis, and white blood cell count showed no group differences. The interval between ED arrival and surgery was not significantly different (P = 0.753). There were no significant differences in the operation duration (P = 0.094), estimated blood loss (P = 0.273), or proportion of drain insertion (P = 0.626). The length of hospital stay (P = 0.681), incidence of postoperative complications (P = 0.894), and postoperative complications according to the Clavien-Dindo classification (P = 0.241) were not significantly different among the groups. Conclusion: Adult patients undergoing laparoscopic appendectomy at our institution during the level 3 alert of the COVID-19 pandemic had no statistically significant differences in perioperative outcomes, including operation time, estimated blood loss, hospital stay, and complication rates.

Automated summary

This study investigated whether there were differences in the perioperative outcomes of laparoscopic appendectomy during the COVID-19 pandemic and found no significant differences between different years.