Laparoscopy in the contemporary management of acute appendicitis

Ekeh, Akpofure Peter; Wozniak, Curtis J.; Monson, Benjamin; Crawford, Joseph William; McCarthy, Mary C.

doi:10.1016/j.amjsurg.2006.09.025

Cited by 22 publications

(16 citation statements)

References 22 publications

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“…Unlike others [7], in our study we did not observe a marked increase in laparoscopic procedures, which tended to be used only in cases of diagnostic uncertainty. Thus, female patients were significantly more likely to undergo a LA allowing the operator to out rule a gynaecological cause in an equivocal case.…”

Section: Discussioncontrasting

confidence: 82%

Current trends in the management of acute appendicitis

Fleming

Drumm

et al. 2008

Ir J Med Sci

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Section: Discussioncontrasting

confidence: 82%

Current trends in the management of acute appendicitis

Fleming

Drumm

et al. 2008

Ir J Med Sci

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“…6,7 It has been stated that removal of a normal looking appendix confers no disadvantage with respect to morbidity or mortality. Indeed, an early or ''microscopic'' appendicitis may not be apparent on macroscopic examination intraoperatively, 8,9 and risks a relaparoscopy or laparotomy if transmural appendiceal inflammation ensues. However, other studies have found that removal of a ''normal'' appendix was associated with increased morbidity such as increased lifetime risk of small bowel obstruction.…”

mentioning

confidence: 98%

Should the Macroscopically Normal Appendix be Removed During Laparoscopy for Acute Right Iliac Fossa Pain When No Other Explanatory Pathology is Found?

Phillips

Jones²,

Sargen³

2009

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques

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“…[18] The use of laparoscopy did not reduce the rate of NA. [19] The aim of this study is to determine the incidence of negative appendectomies in our practice and to identify factors that may reduce the risk of having the normal appendices removed surgically.…”

mentioning

confidence: 99%

Acute appendicitis: Is removal of a normal appendix still existing and can we reduce its rate?

Khairy

2009

Saudi J Gastroenterol

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Background/Aim:To determine the incidence of negative appendectomies and to identify factors that may reduce the risk of having the normal appendices removed surgically.Design:Cross-sectional study.Setting:College of Medicine and King Khalid University Hospital, Riyadh, Saudi Arabia.Materials and Methods:The surgical and histological data of 852 patients who underwent appendicectomy were reviewed. All incidental or interval appendicectomies were excluded. Only patients who were admitted and whose appendices were removed and subjected to histology were included (585 patients). The data on patients who had a normal appendix on histology further analyzed to include demographics, specific investigations, operative findings of the appendix and additional operative findings that need other surgical procedures.Results:A normal appendix was removed in 54 (9.2%) of the patients. Only 5.5% of those patients had a computed tomography (CT) scan preoperatively and 3.7% had diagnostic laparoscopy. In 21 patients, additional operative and histological findings were obtained that might have caused the right lower abdominal pain.Conclusion:In spite of the advances in the diagnostic and imaging techniques, the rates of negative findings on appendicectomy have not decreased much. Clinical judgment is still the most important factor in the management of patients with suspected acute appendicitis. The routine use of CT scan or diagnostic laparoscopy for all patients who are suspected to have appendicitis is neither cost-effective nor safe.

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Laparoscopy in the contemporary management of acute appendicitis

Cited by 22 publications

References 22 publications

Current trends in the management of acute appendicitis

Current trends in the management of acute appendicitis

Should the Macroscopically Normal Appendix be Removed During Laparoscopy for Acute Right Iliac Fossa Pain When No Other Explanatory Pathology is Found?

Acute appendicitis: Is removal of a normal appendix still existing and can we reduce its rate?

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