Laparoscopy reduces unnecessary appendicectomies and improves diagnosis in fertile women. A randomized study.
BACKGROUND
The aim of this study was to study the value of diagnostic laparoscopy prospectively in fertile women scheduled for acute appendectomy.


METHODS
For this study, 110 women, with acute abdominal pain ages 15 to 47 years, in whom the surgeon had decided to perform an appendectomy, were randomized to either open appendectomy or diagnostic laparoscopy, then open appendectomy if necessary.


RESULTS
Appendicitis was diagnosed in 66% of the women after open surgery, and in 73% after laparoscopy. During laparoscopy, was appendicitis misdiagnosed in only 7% of the women, from whom the appendix unnecessarily removed, whereas 34% in the open surgery group had a healthy appendix removed. No appendicitis was missed in the laparoscopic group. The relative risk of removing a healthy appendix in open surgery was 6.6 relative risk (range, 2-21 C.I.) as compared with laparoscopy. Among the women with a healthy appendix, a gynecologic diagnosis was found in 73% after laparoscopy, as compared with 17% after open surgery.


CONCLUSIONS
Laparoscopy reduces unnecessary appendectomies and improves diagnosis in fertile women.
Larsson
P G
PG
Laparscopic Unit, Departments of Gynecology, Skaraborgs, Sjukhus, Sweden.
Henriksson
G
G
Olsson
M
M
Boris
J
J
Ströberg
P
P
Tronstad
S E
SE
Skullman
S
S
D000293:Adolescent; D000328:Adult; D001062:Appendectomy / Q000379:methods / Q000706:statistics & numerical data*; D001064:Appendicitis / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D019564:Unnecessary Procedures