Should Every Patient Undergoing Laparoscopy for Clinical Diagnosis of Appendicitis Have an Appendicectomy ?

Navez, B.; Therasse, Alexis

doi:10.1080/00015458.2003.11679371

Cited by 28 publications

(21 citation statements)

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“…The experience of the laparoscopic team is very important in this context. We generally agree with the algorithm proposed by (Navez & Therasse, 2003) in the treatment of suspected acute appendicitis. The authors propose to remove a macroscopically normal appendix if one suspects an appendicitis clinically and there are no other findings.…”

Section: Diagnostic and Therapeutic Outcomes Of Laparoscopic Appendecsupporting

confidence: 88%

“…It seems that some patients suffer crises of endoappendicitis, that subsides with conservative treatment. Endoappendicitis varies from 11to 26% and the reoperation rate for the patients whose appendix was left in situ is reported to be 6% (Navez and Therasse, 2003). So it might be that the great majority of these patients will not have any problems in the future but for the individual patient the surgeon's decision to leave the appendix behind could mean a readmission, a peritonitis, a second operation, or the persistence of recurrent symptoms.…”

Section: Diagnostic and Therapeutic Outcomes Of Laparoscopic Appendecmentioning

confidence: 99%

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Laparoscopic Appendectomy

Konstantinos¹,

Kornilia²

2011

Updated Topics in Minimally Invasive Abdominal Surgery

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Section: Diagnostic and Therapeutic Outcomes Of Laparoscopic Appendecsupporting

confidence: 88%

Section: Diagnostic and Therapeutic Outcomes Of Laparoscopic Appendecmentioning

confidence: 99%

Laparoscopic Appendectomy

Konstantinos¹,

Kornilia²

2011

Updated Topics in Minimally Invasive Abdominal Surgery

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“…Navez and Therasse did a retrospective study on whether patients undergoing laproscopic exploration for clinical diagnosis of appendicitis should have an appendicectomy. They concluded that if there is no evidence of another cause to explain the acute right iliac fossa pain, it is sensible to proceed with an appendicectomy even if the appendix looks normal, because the rate of re-exploration for recurrent symptoms is considerable, and endoappendicitis defined as inflammation of the appendicular mucosa is seen [8].…”

Section: Discussionmentioning

confidence: 99%

Routine Histopathologic Examination of Two Common Surgical Specimens—Appendix and Gallbladder: Is It a Waste of Expertise and Hospital Resources?

Ramraje

Pawar

2012

Indian J Surg

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This study was undertaken to assess whether a routine histopathologic examination of two common surgical specimens (appendix and gallbladder) is needed and whether routine histopathologic examination has an impact on further management of patients. Histopathology reports of patients who had undergone appendicectomy and cholecystectomy, between 2006 and 2010, were analyzed retrospectively in the department of pathology of a tertiary care hospital. The case notes were retrieved in all cases of malignancies. Patients having a clinical diagnosis or suspicion of malignancy were excluded. The incidence and impact of unexpected pathologic diagnosis on postoperative management were noted. The study period included a total of 1,123 and 711 appendicectomy and cholecystectomy specimens, respectively. Fifteen (1.336 %) cases of appendicectomy specimens revealed incidental unexpected pathological diagnoses, which included tubercular appendicitis (n0 2), parasite (n 08), neuroma (n 01), carcinoid (n 02), pseudomyxoma (n 01), and adenocarcinoma (n 01). About 88 % of such unexpected appendiceal findings had an impact on postoperative treatment. Unexpected pathologic gallbladder findings were found in 12 (1.68 %) of 711 cholecystectomy specimens. In 6 (0.84 %) cases, gallbladder cancer (GBC) was detected. Additional further management was required in 50 % of patients with unexpected gallbladder findings. Twenty of the total 1,834 specimens (1.090 %) had an impact on patient management or outcome and were not suspected on macroscopic examination at the time of surgery. These would have been missed had the specimens not been examined microscopically. The intraoperative diagnosis of the surgeon is therefore sometimes doubtful in detecting abnormalities of the appendix and gallbladder. This study supports the sending of all appendicectomy and cholecystectomy specimens for routine histopathological examination. Appendix and gallbladder should undergo routine histopathological examination. This is important in patients with advanced age and gallstones. Also, it is of great value in identifying unsuspected conditions which require further postoperative management. Selectively sending specimens for histopathological examination can result in reduced workload on the histopathology department without compromising patient safety.

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“…Cases favouring the removal of normal appendix would include those with high clinical suspicion, radiology revealing a faecolith or faecal impaction in the appendix and surgical units where the rate of abscesses is minimal [8]. The presence of 'endoappendicitis' (normal looking serosa but inflammation of inner layers on histology) also justifies this approach [19].…”

Section: Appendicitismentioning

confidence: 99%

Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

et al. 2014

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Laparoscopy has already established itself as the preferred surgical approach in a variety of elective surgical conditions. Along with its usual advantages of less tissue trauma and faster recovery, its diagnostic as well as therapeutic role is making it an attractive option in emergency surgery. In this paper, we have reviewed the current status of laparoscopic surgery in luminal gastrointestinal emergencies. Relevant papers were selected using Medline database from 2007 to the present. These were reviewed, and outcomes were stated under the headings of appendicitis, perforated peptic ulcer, colorectal emergencies and small bowel obstruction. The laparoscopic intervention was found to be of clear benefit in most of the patients with appendicitis. Its role, however, is not absolutely clear in managing perforated peptic ulcers. Laparoscopic lavage and drainage have been recommended in diverticular perforation with limited contamination. Small case series and studies have shown benefits of laparoscopic surgery in iatrogenic colonic perforations, colonic obstruction, emergency colectomy and small bowel obstruction. Laparoscopic surgery can be recommended in appendicitis and lowrisk cases of perforated peptic ulcers. Its definitive role in other conditions needs more evidence. The surgeon's experience and careful patient selection are very important to improve the outcome.

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Should Every Patient Undergoing Laparoscopy for Clinical Diagnosis of Appendicitis Have an Appendicectomy ?

Cited by 28 publications

References 0 publications

Laparoscopic Appendectomy

Laparoscopic Appendectomy

Routine Histopathologic Examination of Two Common Surgical Specimens—Appendix and Gallbladder: Is It a Waste of Expertise and Hospital Resources?

Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

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