title: Pediatric incidental appendectomy: a systematic review.
abstract: Incidental appendectomy is the removal of the vermiform appendix accompanying another operation, without evidence of acute appendicitis. It is generally performed to eliminate the risk of future appendicitis. The risks and benefits of incidental appendectomy during various operations in children have been debated for over a century, but need to be revisited in light of innovations in medical practice, including minimally invasive surgery, improved imaging techniques, and use of the appendix as a tubular conduit for reconstruction. A detailed review was undertaken of the techniques, pathology, risks of appendectomy, utility of the appendix, and incidental appendectomy in the treatment of specific pediatric medical conditions. A comprehensive literature search was performed, and retrieved results were reviewed for relevance to the topic. The decision to perform a pediatric incidental appendectomy relies on informed consideration of the individual patient's co-morbid conditions, the indication for the initial operation, the future utility of the appendix, and the risk of future appendiceal pathology. The discussion includes a variety of situations and comorbid conditions that may influence a surgeon's decision to perform incidental appendectomy.
authors.affiliation: Department of Surgery, Yale University School of Medicine, 333 Cedar Street, TMP202, Box 208062, New Haven, CT, 06520, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Healy
authors.affiliation: Department of Surgery, Yale University School of Medicine, 333 Cedar Street, TMP202, Box 208062, New Haven, CT, 06520, USA.
authors.forename: Lena F
authors.initials: LF
authors.lastname: Olgun
authors.affiliation: Department of Urology, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Hittelman
authors.affiliation: Department of Surgery, Yale University School of Medicine, 333 Cedar Street, TMP202, Box 208062, New Haven, CT, 06520, USA.
authors.forename: Doruk
authors.initials: D
authors.lastname: Ozgediz
authors.affiliation: Department of Surgery, Yale University School of Medicine, 333 Cedar Street, TMP202, Box 208062, New Haven, CT, 06520, USA. michael.caty@yale.edu.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Caty
mesh_terms: D001062:Appendectomy; D001064:Appendicitis / Q000453:epidemiology*; D001065:Appendix / Q000601:surgery*; D002648:Child; D006801:Humans
keywords: Incidental appendectomy; Malone antegrade continence enema; Mitrofanoff; Prophylactic appendectomy