Should an appendicectomy be performed in the presence of a macroscopically healthy appendix, during laparoscopic exploration?
General Surgery department, Ain Taya Hospital, Algiers, Faculty of Medicine of Algiers, Algiers University 1, Algeria.
Research Article
World Journal of Advanced Research and Reviews, 2024, 22(02), 1095-1100
Publication history:
Received on 08 April 2024; revised on 14 May 2024; accepted on 16 May 2024
Abstract:
Introduction: In contrast to the conventional laparotomy approach, the decision to perform an appendicectomy or not in the presence of a macroscopically normal appendix remains contentious during laparoscopic procedures. Our objective is to assess the rate of appendix conservation and conduct a literature review on the management of a macroscopically normal appendix intraoperatively.
Materials and Methods: This was a descriptive, prospective, evaluative study involving 337 patients undergoing laparoscopic surgery for non-traumatic acute abdominal emergencies.
Results: Of the 337 patients operated on, 190 were females (56.4%), with a mean age of 38 years ± 15 years (range 15 to 82 years). In 7 patients (2.1%), the appendix appeared macroscopically normal intraoperatively, despite preoperative diagnosis favoring acute appendicitis. These 7 patients (6 females and 1 male) all underwent thorough clinical examination and preoperative ultrasound, although CT scans were performed in only 3 patients. Among these 7 patients, 2 had ovarian cyst torsions, 2 had ruptured hemorrhagic ovarian cysts, 1 case was diagnosed as retrocaecal internal hernia, and in 2 patients, no etiology was identified. The appendix was preserved in all 7 cases. All patients received postoperative antibiotic therapy. No postoperative complications or surgical reinterventions were recorded.
Conclusion: Our study demonstrates that a macroscopically normal appendix can be left in situ without postoperative complications or need for surgical reintervention.
Keywords:
Appendicitis; Appendectomy; Laparoscopy; Patients
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