“What You See Is Not What You Get” A Plea to Remove A ‘Normal’ Appendix During Diagnostic Laparoscopy

Chiarugi, Massimo; Buccianti, P; Decanini, L; Balestri, Riccardo; Lorenzetti, L; Franceschi, M; Cavina, Enrico

doi:10.1080/00015458.2001.12098626

Cited by 37 publications

(6 citation statements)

References 11 publications

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“… 7 Chiarugi et al also support this argument, demonstrating a high false negative rate for diagnostic laparoscopy with pathological changes found in 58% of normal looking appendices removed. 11 …”

Section: Discussionmentioning

confidence: 99%

An international survey of opinion regarding investigation of possible appendicitis and laparoscopic management of a macroscopically normal appendix

Jaunoo

Hale

Masters

et al. 2012

annals

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INTRODUCTIONThe use of imaging and laparoscopy in patients with right iliac fossa pain as tools to make or exclude a diagnosis of appendicitis is at the discretion of the clinician. We sought to establish a consensus of opinion on this matter by surveying professional bodies for laparoscopic surgery in France, Italy and the US.METHODSA survey was sent to members of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), as well as the French Society for Endoscopic Surgery (SFCE) and the Italian Society for Endoscopic Surgery (SICE). The survey asked about management of both male and female patients presenting with right iliac fossa pain and what operative strategy the respondents would pursue should they find a macroscopically normal appendix at laparoscopy.RESULTSA total of 364 responses were returned from the three groups. The responses from SAGES showed computed tomography to be the preferred modality for investigating patients with right iliac fossa pain, irrespective of sex. Both SFCE and SICE preferred the use of diagnostic laparoscopy, especially in the female patient group. The majority of all respondents stated that they would remove a macroscopically normal appendix at laparoscopy.CONCLUSIONSLaparoscopy remains a potent tool in the management of appendicitis. However, the dilemma of when to remove a macroscopically normal appendix remains. Our study shows that removal of the appendix in this instance would be supported by an international consensus.

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Section: Discussionmentioning

confidence: 99%

An international survey of opinion regarding investigation of possible appendicitis and laparoscopic management of a macroscopically normal appendix

Jaunoo

Hale

Masters

et al. 2012

annals

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“…Many surgeons advocate appendectomy in a macroscopically normal appendix stating that inflammation on the mucosa may be missed 26 , 27 ; others have shown that a normal-looking appendix may be left in place safely. 28 This series has demonstrated that appendicitis can be missed on naked eye examination as shown in Table 2 .…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Laparoscopic Versus Open Appendectomy

Shaikh

Sangrasi

Shaikh

2009

JSLS

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“…In our study, more than 30% of the resected appendices had histological evidence of submucosal inflammation and periappendicitis, although macroscopically they appeared normal. Other authors have described microscopic abnormalities in apparently non-inflamed appendices in similar proportions (27,28) . Performing appendectomy avoids both possible secondary acute appendicitis and subsequent intussusception.…”

Section: Discussionmentioning

confidence: 75%

Incidental appendectomy in surgical treatment of ileocolic intussusception in children. Is it safe to perform?

et al. 2022

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Background. Surgical treatment of ileo-colic intussusception (ICI) has been reported as the second cause of emergency laparotomy in children. The performance of incidental appendectomy after surgical reduction is currently controversial. The aim is to analyse the outcomes of performing incidental appendectomy after surgical ICI reduction with or without associated bowel resection.Materials and methods. A retrospective study was performed in patients with ICI episodes, who underwent surgical treatment in our institution between 2005-2019. Patients were divided in two groups according to the performance of associated appendectomy (AA group) or not (NA group). Subsequently, a stratified analysis was performed according to the need for bowel resection in both groups. Demographic variables, intraoperative findings, surgical time, hospital stay, postoperative complications and recurrences were analysed.Results. A total of 101 patients (77 AA group; 24 NA group) were included, without differences in demographics or intraoperative findings. A total of 36 bowel resections were performed (24 group AA; 10 group NA), with no differences in surgical time (55.7 min in group AA vs. 61.2 min in group NA; p = 0.587) or hospital stay (median 5 days in both groups). There were also no differences in postoperative complications or recurrences between the two groups. Stratified analysis showed that bowel resection increases operative time, hospital stay and postoperative complications, regardless of whether associated appendectomy was performed or not. Conclusions.Incidental appendectomy during surgical treatment of ICI in children is a safe procedure that does not increase operative time, hospital stay, postoperative complications or recurrence.

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“What You See Is Not What You Get” A Plea to Remove A ‘Normal’ Appendix During Diagnostic Laparoscopy

Cited by 37 publications

References 11 publications

An international survey of opinion regarding investigation of possible appendicitis and laparoscopic management of a macroscopically normal appendix

An international survey of opinion regarding investigation of possible appendicitis and laparoscopic management of a macroscopically normal appendix

Clinical Outcomes of Laparoscopic Versus Open Appendectomy

Incidental appendectomy in surgical treatment of ileocolic intussusception in children. Is it safe to perform?

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