The Safety of Incidental Appendectomy at the Time of Total Laparoscopic Hysterectomy

O’Hanlan, Katherine A.; Sten, M.S.; Mo, L.; Halliday, D.M.; Struck, Danielle M.; O’Holleran, M.; Cuff, Justin

doi:10.1016/j.jmig.2018.09.481

Cited by 8 publications

(11 citation statements)

References 21 publications

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“…All of the papers included investigated outcomes following incidental appendicectomies, performed during cholecystectomy (n=4), 14,16,17,18 gynaecological surgery (n=3), 11,12,19 urological surgery (n=1) 20 and trauma surgery (n=1). 13 One study investigated incidental appendicectomy during laparoscopic surgery, 11 with appendicectomies in the remaining eight studies performed during open surgery. No studies described prophylactic surgical removal of the appendix in otherwise well patients.…”

Section: Resultsmentioning

confidence: 99%

“…Short-term complication rates in incidental appendicectomy during gynaecological surgery were reported in one retrospective observational study 11 and two non-randomised prospective studies. 12,19 No differences in short-term complication rates were reported compared with controls.…”

Section: Incidental Appendicectomy During Gynaecological Surgerymentioning

confidence: 99%

“…Performing incidental appendicectomies (defined as the surgical removal of a normal appendix during an operation primarily for a different condition) is well documented. [9][10][11][12][13][14] However, the practice of elective prophylactic appendicectomy (defined as the surgical removal of a normal appendix in the absence of other procedures) is controversial. This paper examines the risks and benefits of prophylactic surgery, and presents a case example where prophylactic appendicectomy was performed that resulted in fatal adhesion related long-term complications but without shortterm compromise in the field.…”

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confidence: 99%

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Systematic review of clinical outcomes after prophylactic surgery

Davis

Trevatt

Dixit

et al. 2016

annals

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Introduction Prophylactic appendicectomy is performed prior to military, polar and space expeditions to prevent acute appendicitis in the field. However, the risk-benefit ratio of prophylactic surgery is controversial. This study aimed to systematically review the evidence for prophylactic appendicectomy. It is supplemented by a clinical example of prophylactic surgery resulting in life-threatening complications. Methods A systematic review was performed using MEDLINE(®) and the Cochrane Central Register of Controlled Trials. Keyword variants of 'prophylaxis' and 'appendicectomy' were combined to identify potential papers for inclusion. Papers related to prophylactic appendicectomy risks and benefits were reviewed. Results Overall, 511 papers were identified, with 37 papers satisfying the inclusion criteria. Nine reported outcomes after incidental appendicectomy during concurrent surgical procedures. No papers focused explicitly on prophylactic appendicectomy in asymptomatic patients. The clinical example outlined acute obstruction secondary to adhesions from a prophylactic appendicectomy. Complications after elective appendicectomy versus the natural history of acute appendicitis in scenarios such as polar expeditions or covert operations suggest prophylactic appendicectomy may be appropriate prior to extreme situations. Nevertheless, the long-term risk of adhesion related complications render prophylactic appendicectomy feasible only when the short-term risk of acute appendicitis outweighs the long-term risks of surgery. Conclusions Prophylactic appendicectomy is rarely performed and not without risk. This is the first documented evidence of long-term complications following prophylactic appendicectomy. Surgery should be considered on an individual basis by balancing the risks of acute appendicitis in the field with the potential consequences of an otherwise unnecessary surgical procedure in a healthy patient.

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Section: Resultsmentioning

confidence: 99%

Section: Incidental Appendicectomy During Gynaecological Surgerymentioning

confidence: 99%

mentioning

confidence: 99%

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Systematic review of clinical outcomes after prophylactic surgery

Davis

Trevatt

Dixit

et al. 2016

annals

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“…18 There are studies to support incidental appendicectomy is a safe procedure in women undergoing elective surgery without any significant morbidity or increase in the length of stay for this added procedure. 19,20 Table 3 summarizes the correlation between the histological or microscopic appearance and the macroscopic appearance of appendices removed as part of staging procedure for borderline and malignant MOT. The studies that do not clearly mention the microscopic and macroscopic correlation have not been included in Table 3.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Appendicectomies at Surgery for Mucinous Ovarian Neoplasms: Report From A UK Center and Review of Literature

Mukhopadhyay

Rajab

Nobbenhuis

et al. 2016

Int J Gynecol Cancer

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“…In addition, the ease of resection, low morbidity, and absence of additional anesthetic risks enable incidental appendectomy during non-appendiceal surgery [3][4][5][6][7][8][9][10]. On the other hand, it has been reported that incidental appendectomy contravenes surgical principles by risking contamination, increasing operative time, and morbidity [7,11].…”

Section: Introductionmentioning

confidence: 99%

The Benefits and Risks of Performing Incidental Appendectomy

Lee

Sul

et al. 2019

J Acute Care Surg

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Acute appendicitis is the most common indication for emergency abdominal surgery worldwide. The risks and benefits of incidental appendectomy during other operations have been debated for over a century. There is no right answer to the question of whether or not to perform incidental appendectomy. Although there are only a few indications where it is explicitly recommended such as in gynecological surgery, malrotation, and Ladd's procedure, incidental appendectomy is cost-effective in selected patient groups, especially in the young, without an increase in morbidity and mortality. In this review, the literature on incidental appendectomy was assessed from several perspectives.

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The Safety of Incidental Appendectomy at the Time of Total Laparoscopic Hysterectomy

Cited by 8 publications

References 21 publications

Systematic review of clinical outcomes after prophylactic surgery

Systematic review of clinical outcomes after prophylactic surgery

Outcome of Appendicectomies at Surgery for Mucinous Ovarian Neoplasms: Report From A UK Center and Review of Literature

The Benefits and Risks of Performing Incidental Appendectomy

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