title: Long-term benefits of laparoscopic appendectomy for chronic abdominal pain in fertile women.
abstract: OBJECTIVE
  To assess long-term benefit of laparoscopic appendectomy for chronic abdominal pain of unknown origin in fertile women.
  
  
  METHODS
  The study included 70 fertile women aged 29.2+/-13.1 years who had undergone diagnostic laparoscopy for recurrent abdominal pain at our Department between 1996 and 2000. In December 2002, a questionnaire with symptom-specific questions and procedure-specific questions was sent to all the patients. The response rate was 76% (53 out of 70).
  
  
  RESULTS
  According to intraoperative findings there were 8 patients with adhesions, 12 with gynecological origin of pain, 27 with chronic inflammation or narrowed lumen of the appendix, and 6 with normal laparoscopic findings and innocent appendix. The most common intervention was appendectomy, performed in 41 out of 53 cases; cysts fenestration in 10 cases; and lysis of adhesions in 8. The average hospital stay was 3.6+/-2.6 days. Postoperative complications occurred in 10/53 patients. A serious complication involving bladder injury after lysis of adhesions occurred in a single patient. There was no mortality. 3 out of 53 patients were readmitted 1, 3, and 9 months postoperatively because of residual abdominal pain. Two of them had appendectomy. Long-term follow up showed that there were no differences in the overall satisfaction with diagnostic laparoscopy in the patients with (n=41) and without appendectomy (n=12). There was no difference in overall satisfaction between the patients having inflamed appendix (n=22) and those without inflamed appendix (n=19).
  
  
  CONCLUSIONS
  Diagnostic laparoscopy is a diagnostic and therapeutic option in most fertile women with chronic abdominal right iliac fossa pain of unknown origin. Our results showed low postoperative complications and no mortality rate with laparoscopic appendectomy indicate removal of appendix as a part of diagnostic laparoscopy when the origin of pain is unknown. In some cases of persistent pain, the removal of appendix is beneficial by eliminating appendicitis in differential diagnosis.
authors.affiliation: Department of Surgery, Dr Ivo Pedisić General Hospital, Sisak, Croatia. drago.popovic@zg.tel.hr
authors.forename: Drago
authors.initials: D
authors.lastname: Popović
authors.forename: Jadranko
authors.initials: J
authors.lastname: Kovjanić
authors.forename: Damir
authors.initials: D
authors.lastname: Milostic
authors.forename: Darko
authors.initials: D
authors.lastname: Kolar
authors.forename: Davorin
authors.initials: D
authors.lastname: Stojaković
authors.forename: Zelimir
authors.initials: Z
authors.lastname: Obradović
authors.forename: Franjo
authors.initials: F
authors.lastname: Lovrencić
authors.forename: Anton
authors.initials: A
authors.lastname: Franceschi
authors.forename: Mladen
authors.initials: M
authors.lastname: Loparić
authors.forename: Robert
authors.initials: R
authors.lastname: Gjoni
authors.forename: Miroslav
authors.initials: M
authors.lastname: Anadolac
authors.forename: Miroslav
authors.initials: M
authors.lastname: Petracić
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Borovina
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D000328:Adult; D001062:Appendectomy / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012008:Recurrence; D011795:Surveys and Questionnaires; D013995:Time