title: Laparoscopic stapler appendectomy. A prospective study of 267 consecutive cases.
abstract: BACKGROUND
  The value of laparoscopic appendectomy remains controversial. Therefore, we investigated the accuracy of diagnostic laparoscopy in detecting acute appendicitis and tested the applicability and safety of stapling appendectomy as a routine procedure.
  
  
  METHODS
  Data from 267 consecutive patients with suspicion of acute appendicitis were recorded prospectively.
  
  
  RESULTS
  Histopathological examination revealed nonperforated and perforated appendicitis in 63.3% and 13.1%, respectively, and no inflammation in 10.8%. Other pathological findings were observed in 12.7%. Diagnostic laparoscopy detected appendicitis with a sensitivity and specificity of 95.6% and 96.6%, respectively; the positive and negative predictive value were 99.5% and 74.3%, respectively. Morbidity was 10.2% in total and 40% for perforated appendicitis. Planned laparoscopic reexploration reduced morbidity by 23.4% in patients with perforated appendicitis and substantial peritonitis. Mortality was 0.4%.
  
  
  CONCLUSIONS
  Laparoscopy improves diagnostic accuracy for acute appendicitis and laparoscopic stapling appendectomy is a safe and efficient procedure for all forms of appendicitis.
authors.affiliation: Surgical Department, Spital Aarberg, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Wagner
authors.forename: D
authors.initials: D
authors.lastname: Aronsky
authors.forename: J
authors.initials: J
authors.lastname: Tschudi
authors.forename: A
authors.initials: A
authors.lastname: Metzger
authors.forename: C
authors.initials: C
authors.lastname: Klaiber
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000601:surgery; D011446:Prospective Studies; D012680:Sensitivity and Specificity