Morbidity after negative appendectomy: a single-centre experience on 627 cases

Tamini, Nicolò; Santurro, Letizia; Chiappetta, Maria Francesca; Gattuso, Ilaria; Barbieri, Consuelo; Fattori, Luca; Gianotti, Luca

doi:10.1007/s00068-019-01138-w

Cited by 19 publications

(9 citation statements)

References 25 publications

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“…Reasons adduced for this observation includes the gynaecological conditions that could mimic the presentation of acute appendicitis. Ovarian cysts, leiomyoma, endometriosis, benign ovarian neoplasms, malignant ovarian disease, pelvic adhesions have been reportedly misdiagnosed as acute appendicitis in women [9]. Our audit showed an overall negative appendectomy rate of 17% while it is 9.7% in male and 31% in female patients.…”

Section: Discussionmentioning

confidence: 66%

Radiological Correlation of Negative Appendectomies: A Clinical Audit

Ishaq¹,

Naureen²,

Amin³

et al. 2021

RDI

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Introduction: Appendectomy is the most common surgical emergency and negative appendectomy is a one of recognized consequence of appendectomy. Recently an increased use of radiology is seen in diagnosing appendicitis and it has significantly decreased the rate of negative appendectomy. Every effort should be made to establish an exact diagnosis. If, however, this is impossible and a suspicion of appendicitis exists, exploration is mandatory. It is far better to subject a moderate number of patients to a theoretically unnecessary operation than to let one patient suffer perforation. Aim: Recently we have seen an increased use of radiology in our department for diagnosing appendicitis. The idea of conducting this audit was to calculate our negative appendectomy rate by correlating it with use of radiology and to compare it with international figures and to set up guidelines for use of radiology in diagnosing appendicitis on basis of results of our audit. Methods: Records of all patients who underwent appendectomy in Dubai Hospital, UAE from Jan 2018 to Jan 2019 were retrospectively analysed using electronic record system. Clinical diagnosis and radiological findings were compared with histopathology as gold standard for negative appendectomy rate. The sensitivity and specificity of different radiological procedures was calculated as well. Results: Total 165 patients underwent appendectomy in specified duration. Overall negative appendectomy rate was 17% with male being 9.7% and female rate 31%. CT scan was found to be 100% specific and 91.4% sensitive in diagnosing appendicitis while clinical diagnosis was accurate in 88.5% cases.

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Section: Discussionmentioning

confidence: 66%

Radiological Correlation of Negative Appendectomies: A Clinical Audit

Ishaq¹,

Naureen²,

Amin³

et al. 2021

RDI

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“…The rate of appendicitis vermiformis was 15.3%. The rate of negative appendectomy has been reported in the literature as between 4-15% (13,14). The cause of high negative appendectomy rates is the fear of perforation and they have an inverse correlation (15).…”

Section: Discussionmentioning

confidence: 99%

Seasonal Pattern of Acute Appendicitis in Central Anatolia

Topal¹

2020

Erciyes Med J

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The most common cause of acute abdomen requiring surgical intervention globally is acute appendicitis (AA). In this study, we aimed to investigate how AA diagnosis is affected by seasonal changes in Central Anatolia. Materials and Methods: In this study, patients who underwent appendectomy with the diagnosis of (AA) between January 1, 2015 and January 1,2019 were evaluated retrospectively. We divided the patients into three groups based on their histopathological results: Group 1 Acute Appendicitis (AA), Group 2 Appendix vermiformis (AV) and Group 3 Perforated appendicitis (PA). Patients were evaluated concerning age, sex and season of operation. Results: Seven hundred ninety-five patients participated in our study. They were separated into the following groups: Group 1 (n=614), Group 2 (n=125), and Group 3 (n=56). Concerning the sex variable, no statistically significant differences were found between the groups (p=0.061). The mean age of the patients in the perforated appendicitis group was higher when compared to the other groups (p=0.001). When evaluated by season, it was seen that during winter, the patients in Group 1 were significantly higher than the patients in the other groups (p=0.009). In our study, acute appendicitis was most frequently diagnosed during winter (28.7%); appendix vermiformis was most frequently diagnosed during spring (32%) and perforated appendicitis was most frequently diagnosed during summer (41%). Conclusion: Although the diagnosis of acute appendicitis varies seasonally, age and seasonal changes may be effective in the frequency of acute appendicitis. In Central Anatolia, the incidence of acute appendicitis increased during winter, while the rate of perforated appendicitis increased in summer and the rate of negative appendectomy increased in spring.

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“…Consensus guidelines support early surgery without pre‐operative imaging only in patients with a high clinical suspicion of appendicitis 3 . Post‐operatively, negative appendectomies have complication rates comparable to positive appendectomies 9,10 . Longer hospital length of stay has been observed following negative appendicectomy and consistently higher costs of admission 11 …”

Section: Introductionmentioning

confidence: 99%

“…3 Post-operatively, negative appendectomies have complication rates comparable to positive appendectomies. 9,10 Longer hospital length of stay has been observed following negative appendicectomy and consistently higher costs of admission. 11 Published paediatric negative appendicectomy rates are variable but have been seen to decline over the last two decades.…”

Section: Introductionmentioning

confidence: 99%

Paediatric negative appendicectomy rates at a regional Western Australian Centre: a five‐year cohort study

Behrendorff

Palan

McKitterick

et al. 2023

ANZ Journal of Surgery

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BackgroundIn acute appendicitis, decision‐making around operative intervention for paediatric patients differs from adults due to a higher weight placed on clinical assessment and reduced rates of cross‐sectional imaging. In regional settings, non‐paediatric emergency doctors, general surgeons, and radiologists usually assess and manage this patient group. Differences have been observed in paediatric negative appendicectomy rates between general and paediatric centres.MethodsA retrospective cohort study was performed, identifying paediatric patients undergoing emergency appendicectomy at the Southwest Health Campus (Bunbury, Western Australia) from 2017 to 2021. The primary outcome measure was histopathology confirming the absence of transmural inflammation of the appendix. In addition, clinical, biochemical and radiological data were collected to identify predictors of negative appendicectomy (NA). Secondary outcome measures were hospital length‐of‐stay and post‐operative complication rates.ResultsFour hundred and twenty‐one patients were identified, of which 44.9% had a negative appendicectomy. Statistically significant associations between female gender, white cell count less than 10 × 109, neutrophil ratio less than 75%, low CRP and NA were observed. NA was not associated with a lower risk of re‐admission or complications compared with appendicectomy for appendicitis.ConclusionsOur centre's NA rate is higher than that observed in the literature at both non‐paediatric and paediatric surgical centres. NA has similar morbidity risk to appendicectomy for uncomplicated appendicitis and offers a timely reminder that diagnostic laparoscopy in children is not benign.

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Morbidity after negative appendectomy: a single-centre experience on 627 cases

Cited by 19 publications

References 25 publications

Radiological Correlation of Negative Appendectomies: A Clinical Audit

Radiological Correlation of Negative Appendectomies: A Clinical Audit

Seasonal Pattern of Acute Appendicitis in Central Anatolia

Paediatric negative appendicectomy rates at a regional Western Australian Centre: a five‐year cohort study

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