title: The selective use of fine catheter peritoneal cytology and laparoscopy reduces the unnecessary appendicectomy rate.
abstract: The effect of a management protocol incorporating the selective use of fine catheter peritoneal cytology (FCPC) and laparoscopy on the unnecessary appendicectomy rate was studied in adult patients (> or = 16 years) treated at one district general hospital over an 11-month period. Appendicectomy was performed on 62 adult patients managed according to this protocol, six (10%) of whom had a histologically normal appendix and no other acute condition requiring surgery. A further 57 patients underwent appendicectomy after standard clinical assessment and investigation without the use of FCPC or laparoscopy. Nineteen (33%) of these patients had a histologically normal appendix removed, with no other acute condition requiring surgical treatment. The selective use of FCPC and laparoscopy significantly reduced the unnecessary appendicectomy rate from 33% to 10% (chi 2 = 10.0, P < 0.005). The more widespread use of these techniques in patients with suspected appendicitis is therefore recommended.
authors.affiliation: Department of Surgery, Ealing Hospital, Middlesex.
authors.forename: R J
authors.initials: RJ
authors.lastname: Baigrie
authors.forename: D
authors.initials: D
authors.lastname: Scott-Coombes
authors.forename: Z
authors.initials: Z
authors.lastname: Saidan
authors.forename: M N
authors.initials: MN
authors.lastname: Vipond
authors.forename: S
authors.initials: S
authors.lastname: Paterson-Brown
authors.forename: J N
authors.initials: JN
authors.lastname: Thompson
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology; D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000473:pathology / Q000601:surgery*; D001065:Appendix / Q000473:pathology; D002404:Catheterization; D002985:Clinical Protocols; D003663:Decision Trees; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male