为了评估对于无并发症急性阑尾炎患者的门诊阑尾切除手术在安全性、疗效和经济效益方面的作用。鉴于急性阑尾炎是急性腹痛最常见的病因，引入门诊阑尾切除手术方案可以显著提高医疗保健系统的效力和可持续性。共有300名患者参与了自2018年10月至2021年6月间进行的PENDI-CSI随机临床试验：其中149名被分配至门诊手术组（OPS），151名被分配至住院手术组（IPS），并于术后一个月进行随访。所有患者年龄均大于14岁，并且患有无并发症急性阑尾炎。排除标准包括妊娠、肿瘤、炎症性肠病和高麻醉风险（ASA IV）。OPS组患者在麻醉后的恢复室出院，而IPS组患者被住院。总共有128名OPS组患者（85.9%）无需住院而出院。OPS组患者需住院的预测因素有年龄超过31岁 [RR 2.42(1.04-5.65)]、高血压 [RR 6.21(3.22-11.97)]、麻醉风险II-III [RR 2.63(1.17-5.94)]、先前腹部手术史 [RR 3.34(1.55-7.20)]、术后VAS>6的疼痛 [RR 4.28(2.67-6.86)] 和术后恐惧感 [RR 2.2(1.04-4.67)]。并发症、再入院和再手术方面两组无差异，并且在两组中的感知质量相似。门诊手术方式可使每名患者节约1034.97欧元（P < 0.001）。对于无并发症急性阑尾炎，门诊阑尾切除手术是安全有效的。患者感知的质量与住院手术相似，尽管它成功降低了住院阑尾切除手术的医院费用。版权所有 © 2023 Wolters Kluwer Health, Inc. 保留所有权利。

To evaluate the safety, efficacy, and cost-effectiveness of outpatient appendectomy in patients with uncomplicated acute appendicitis.Given that acute appendicitis is the most common cause of acute abdomen, the introduction of outpatient appendectomy protocols could significantly improve the effectiveness and sustainability of healthcare systems.A total of 300 patients were enrolled from October 2018 to June 2021 in the PENDI-CSI randomized clinical trial:149 were assigned to the outpatient surgery group (OPS) and 151 to the inpatient surgery group (IPS), followed by one month postoperatively. All patients were aged > 14 years and had uncomplicated acute appendicitis. Exclusion criteria were pregnancy, neoplasms, inflammatory bowel disease, and high anesthetic risk (ASA IV). The OPS group was discharged from the post-anesthesia care unit while the IPS group was admitted.In total, 128 patients in the OPS group (85.9%) were discharged without admission. Predictors whether patients in the OPS group had to be admitted were aged over 31 years [RR 2.42(1.04-5.65)], hypertension [RR 6.21(3.22-11.97)], anesthetic risk II-III [RR 2.63(1.17-5.94)], previous abdominal surgery [RR 3.34(1.55-7.20)], postoperative pain with VAS>6 [RR 4.28(2.67-6.86)], and postoperative fear [RR 2.2(1.04-4.67)]. There were no differences in terms of complications, readmissions, and reinterventions, and the perceived quality was similar in both groups. The outpatient modality produced savings of €1 034.97 per patient (P-value < 0.001).Outpatient appendectomy is safe and effective for uncomplicated acute appendicitis. Patient-perceived quality is similar to that of inpatient surgery, although it successfully reduces hospital costs compared to inpatient appendectomy.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.