Postoperative outcomes in laparoscopic appendicectomies with histopathologically normal appendix

Abstract

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.