Same Day Ambulatory Appendectomy (SAMBA)

Inclusion Criteria:

• Patients aged 15-74 years

• BMI ≤ 35 kg/m2

• Uncomplicated acute appendicitis confirmed by imaging (ultrasound and/or CT and/orMRI)

• Temperature ≤ 38,1°C and > 35,5°C

• Appendix diameter > 6mm and ≤ 15mm

• Without effusion or with only localized peri-appendicular effusion

• Infiltration of peri-appendicular fat without abscess or plastron

• No sign of perforation

• Leukocytes ≤ 18,000G/L AND

• CRP (C reactive protein) ≤ 60mg/L

• If pain, calmed by level 3 analgesic at maximum

• Ambulatory criteria

• Availability of monitoring by a relative during the 12 hours after dischargefrom the hospital

• Residence located less than 20 minutes by car from a health center (hospital orclinic)

• Access to a telephone mobile or fixed in case of problems

• Signature of the written informed consent form by the patient

• If the patient is a minor, signature of the written informed consent form by bothparents or their legal representative

• Affiliation to a French health insurance scheme or equivalent

Exclusion Criteria:

• Criteria that exclude ambulatory care such as an ASA score (Physical status score) > 2, severe or uncontrolled comorbidities, severe pulmonary disease includingobstructive sleep apnea, anticoagulation or antiplatelet drug or contraindication toambulatory surgery such as intubation difficulties

• Presence of active cancer, a malignant hemopathy, drug addiction, coagulopathy,immunosuppressive treatment

• Non-acute or interval appendectomy, i.e. after antibiotic treatment of a complicatedappendicitis of the plastron or drainage of an appendicular abscess;

• History of pelvic surgery

• Vulnerable people: pregnant or breast-feeding women (patients will undergo apregnancy test: plasmatic β-hCG (human chorionic gonadotropin) or urinary test),adult under guardianship or deprived of freedom. Pregnant women are considered tohave a full stomach, with risk of inhalation at anesthetic induction and represent acontraindication to ambulatory surgery. In addition, the need to perform abdominalsurgery on a pregnant woman requires obstetric monitoring that is difficult toreconcile with management in an outpatient surgery unit (need for obstetricultrasound or monitoring).

• Suspicion of a tumor of the appendix : Mucocele and pseudomyxoma, Carcinoid tumor,Adenocarcinoma of the appendix, Another type of tumor