Prediction of inflammation of the appendix at open and laparoscopic appendicectomy: findings and consequences.
OBJECTIVE
To evaluate the accuracy of operative assessment of the condition of the appendix during laparoscopic and open appendicectomy, and to assess whether a normal-looking appendix should be excised routinely during a laparoscopic operation.


METHODS
Prospective study.


METHODS
District general hospital, UK.


METHODS
387 patients who presented with signs and symptoms of appendicitis and underwent appendicectomy.


METHODS
63 patients (16%) were operated on laparoscopically, of whom 48 were female.


METHODS
Correlation of operative with histological findings.


RESULTS
The positive predictive value of operative assessment was increased during the laparoscopic procedure in both male (94.4% to 100%) and female (78% to 88%) patients. Of 21 female patients whose appendixes looked normal at laparoscopy, 5 had other conditions (appendixes normal on histological examination) and 4 were inflamed.


CONCLUSIONS
In women of childbearing age a normal-looking appendix should be resected during laparoscopic appendicectomy unless another condition is obviously the cause of the signs and symptoms.
Al-Ghnaniem
Reyad
R
Academic Department of Surgery, King's College Hospital, London, United Kingdom.
Kocher
Hemant M
HM
Patel
Ameet G
AG
D000328:Adult; D001062:Appendectomy / Q000379:methods; D001064:Appendicitis / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D001065:Appendix / Q000473:pathology*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011237:Predictive Value of Tests