Laparoscopic surgery in women with a clinical diagnosis of acute appendicitis.
OBJECTIVE
To assess the routine use of diagnostic laparoscopy and laparoscopic appendicectomy in women with a clinical diagnosis of acute appendicitis.


METHODS
Women who presented with a clinical diagnosis of acute appendicitis between 1 January 1992 and 31 August 1993 were prospectively assessed and 107 underwent diagnostic laparoscopy.


RESULTS
Appendicitis was confirmed in 63 women (59%) and no diagnosis could be made in seven (6%). An alternative diagnosis, most commonly a gynaecological disorder, was made in 37 women (35%). Twenty-eight women with an alternative diagnosis (76%) did not require a laparotomy. Seventy-three patients had a laparoscopic appendicectomy, with an 8% conversion rate to an open operation. The morbidity rate for laparoscopic procedures was 3%, the median inpatient stay was two days and the median time to return to normal activities was eight days.


CONCLUSIONS
Diagnostic laparoscopy should be performed in women who present with a clinical diagnosis of acute appendicitis to confirm the diagnosis, reduce the rate of unnecessary appendicectomy and avoid an unnecessary laparotomy. When acute appendicitis is confirmed, appendicectomy may be performed laparoscopically.
Department of Surgery, Flinders Medical Centre, Adelaide, SA.
M R
MR
Cox
J L
JL
McCall
R T
RT
Padbury
T G
TG
Wilson
D A
DA
Wattchow
J
J
Toouli
D000203:Activities of Daily Living; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D001064:Appendicitis / Q000175:diagnosis* / Q000601:surgery*; D002429:Cecal Diseases / Q000175:diagnosis / Q000601:surgery; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007079:Ileitis / Q000175:diagnosis; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007813:Laparotomy; D007902:Length of Stay; D008199:Lymphadenitis / Q000175:diagnosis; D008643:Mesentery; D008875:Middle Aged; D011446:Prospective Studies; D012488:Salpingitis / Q000175:diagnosis / Q000188:drug therapy