title: Diffusion of laparoscopic appendectomies in Italy: a national audit.
abstract: A national audit focused on laparoscopic appendectomy was promoted by the Italian Association of Hospital Surgeons (ACOI). Four-hundred and sixty surgical practices received an e-mail questionnaire. Data concerning epidemiology, timetable, surgeon's age, selection of patients, laparotomic conversion, behaviour in the case of a normal appendix, and technical aspects were investigated. The response rate was 51.7%. The median number of appendectomies performed is 50-100 each year in a surgery ward. Laparoscopic operations are very common (93%), but mostly performed in less than 50% of the observed cases. There is no significant difference between the number of operations during the day vs. at night, and they are performed by a limited (<30%) group of surgeons, equally composed of physicians aged above and below 40. The majority of surgeons adopt an "all comers" policy regarding laparoscopic appendectomy, including selected older patients (>70 years old). There are no standard indications for conversion, while the behaviour in the presence of a normal appendix is generally removal. Even if laparoscopic appendectomy is not yet considered a gold standard, it is widely diffused in Italy, and the audit's data show different behaviours between subgroups.
authors.affiliation: Chirurgia Generale e Vascolare, A.O. M. Mellini, Chiari (BS), Italy. nereovet@gmail.com
authors.forename: Nereo
authors.initials: N
authors.lastname: Vettoretto
authors.forename: Sara
authors.initials: S
authors.lastname: Gobbi
authors.forename: Fiorenza
authors.initials: F
authors.lastname: Belli
authors.forename: Alessio
authors.initials: A
authors.lastname: Corradi
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Mannino
authors.forename: Luigi
authors.initials: L
authors.lastname: Ricciardelli
authors.forename: Marina
authors.initials: M
authors.lastname: Vinciguerra
authors.forename: Davide
authors.initials: D
authors.lastname: Piccolo
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001062:Appendectomy / Q000379:methods* / Q000706:statistics & numerical data; D001064:Appendicitis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008485:Medical Audit; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires