The treatment of choice is appendicectomy and trials have suggested that, although the laparoscopic approach may have some advantages, there is no clear benefit of this over the open approach. As a consequence, the method of appendicectomy is often dictated by operator experience and facilities available. The majority of recent studies on the management of patients having an appendicectomy are from within the confines of a clinical trial and, due to selection criteria, do not reflect the whole patient case load undergoing the procedure. Most patients recover quickly from appendicectomy but a minority can suffer postoperative complications. This review of case notes was undertaken to assess the frequency of these complications in unselected patients.
Patients and MethodsAdult patients (> 16 years of age) undergoing an emergency appendicectomy in the 12-month period between 1 February 2004 and 31 January 2005 were identified from a key word search of 'appendix' from pathology and theatre record databases. Details of presenting symptoms, time to operation, operative procedure, histology and postoperative complications were obtained from the patients' case notes. A complicated recovery was assumed to have occurred if a patient did not recover in the conventional manner. This was defined by the presence of a complication which prolonged the postoperative stay for >4days, admission to a critical care area and/or the need for re-operation or re-admission. Complications were divided into septic (i.e. infective) or non-septic depending on the nature and aetiology. Appendicitis is the most common cause of the acute abdomen and can affect all age groups. Most patients recover quickly but a minority can suffer postoperative complications. This case-note review was undertaken to assess the frequency of these complications.