Postoperative outcomes in laparoscopic appendicectomies with histopathologically normal appendix

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COD: 01_2019_11_2940 Categorie: ,

Dimitrios Zosimas, Panagis M. Lykoudis, Josh Burke, Giuseppe Strano, Phoebe Leung, Veeranna Shatkar

Ann Ital Chir, 2019 90, 1: 72-77
Epub Ahead of Print – November 19

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AIM: Although still debatable, appendicectomy during laparoscopy in patients with abdominal pain is often performed
even if the appendix seems normal. The study’s aim is to compare the postoperative outcomes of laparoscopic appendicectomies
with appendix proven to be histologically normal to those with proven appendicitis, adding evidence on
whether a normal appendix should be removed.
METHODS: All consecutive patients who underwent laparoscopic appendicectomy in a one-year period in a single centre
were retrospectively studied. Comparison was attempted between patients with negative and positive histology with regards
to their postoperative outcomes (length of stay and postoperative complications).
RESULTS: Out of 134 patients included in the study, ten patients developed postoperative complications (7.5%), 42
patients had negative histology (31.3%), 92 patients had positive histology (68.7%) and six (14.3%) and four patients
(4.3%) respectively from each group developed post-operative complications. No statistically significant difference was found
regarding morbidity, length of stay and Clavien-Dindo grading of complications between the two groups.
DISCUSSION: Morbidity and length of stay in laparoscopic appendicectomy with normal appendix are not inferior to those
with histologically confirmed appendicitis and thus should not be disregarded when considering a routine appendicectomy.
CONCLUSION: The final decision to remove a normal appendix in laparoscopy for abdominal pain should be based on
the individual clinical scenario and surgeon’s experience.