title: Laparoscopic accuracy in prediction of appendiceal pathology: oncologic and inflammatory aspects.
abstract: BACKGROUND
  In the prelaparoscopy era, macroscopically normal appendices were routinely resected. The aim of this study was to evaluate the accuracy of laparoscopy.
  
  
  METHODS
  A review of 1,899 patients who underwent appendectomy with multivariate analysis was conducted.
  
  
  RESULTS
  Laparoscopic and open approaches had similar false-positive rates, false-negative rates, accuracy, and sensitivity. The study population included 17 false-negative cases (11% of all macroscopically normal appendices). Tumors were found in 1.1% of our study population. Female gender (1.9% vs. .5%; odds ratio, 4; 95% confidence interval, 1.5 to 11; P < .005) and appendiceal perforation were independent risk factors for harboring a tumor.
  
  
  CONCLUSIONS
  It is suggested that laparoscopy has diagnostic quality similar to that of the open approach. Until randomized trials evaluate the fate of patients who receive false-negative diagnoses, routine appendectomy is recommended. Special attention should be paid to female patients and to patients with perforations, who have a 4-fold increased risk for harboring a tumor.
authors.affiliation: Department of Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: eransadot@gmail.com.
authors.forename: Eran
authors.initials: E
authors.lastname: Sadot
authors.forename: Andrei
authors.initials: A
authors.lastname: Keidar
authors.forename: Ron
authors.initials: R
authors.lastname: Shapiro
authors.forename: Nir
authors.initials: N
authors.lastname: Wasserberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000009:adverse effects; D001063:Appendiceal Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D001064:Appendicitis / Q000175:diagnosis* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003951:Diagnostic Errors; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D055815:Young Adult
keywords: Appendectomy; Appendicitis; Laparoscopy; Macroscopic; Tumor