Same Day Ambulatory Appendectomy (SAMBA)

Inclusion Criteria:

• Patients aged 15-74 years
• BMI ≤ 30 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 ≤ 15,000G/L AND
• CRP (C reactive protein) ≤ 50mg/L
• If pain, calmed by level 2 analgesic at maximum
• Ambulatory criteria
• Availability of monitoring by a relative during the 12 hours after discharge fromthe 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 a pregnancytest: plasmatic β-hCG (human chorionic gonadotropin) or urinary test), adult underguardianship or deprived of freedom. Pregnant women are considered to have a fullstomach, 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 obstetric ultrasoundor monitoring).
• Suspicion of a tumor of the appendix : Mucocele and pseudomyxoma, Carcinoid tumor,Adenocarcinoma of the appendix, Another type of tumor