Prospective Study of Early Versus Delayed Appendicectomy in the Treatment of Acute Appendicitis at Jos University Teaching Hospital

Abstract

Background: Acute appendicitis is a common surgical emergency in Nigeria, with early appendicectomy traditionally regarded as the standard treatment to minimize complications. However, the optimal timing of surgery remains controversial. This study aimed to compare the peri-operative outcomes of early versus delayed appendicectomy in patients with acute appendicitis, thereby assessing whether surgical timing influences clinical outcomes and determining the approach associated with better peri-operative results. Methodology: This was a prospective randomized controlled study carried out at the Jos University Teaching Hospital. Patients were randomized into an early (within 12 hours of presentation) and delayed (up to 24 hours) appendicectomy groups. Their 30-day post-operative outcome was analysed using SPSS Version 25. Results: Fifty-six participants (28 on each arm) completed the study. Surgical site infection developed in 3 (10.7%) and 2 (7.1%) patients from the early and late appendicectomy groups, respectively (p = 1). There was no statistically significant difference in the perforation rate, cost of care or length of hospital stay between the two groups. No mortality was recorded. Conclusion: This study showed no statistically significant difference between the outcome of patients who had early appendicectomy and that of those who had delayed appendicectomy. Hence, appendicectomy for acute appendicitis can be safely delayed for up to 24 hours from diagnosis, provided the patients are promptly commenced on antibiotics.