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A normal appendix found during diagnostic laparoscopy should not be removed.

W T van den Broek1, A B Bijnen, P de Ruiter

  • 1Department of Surgery, Medical Centre Alkmaar, Alkmaar, The Netherlands. w.broek@wolmail.nl

The British Journal of Surgery
|February 13, 2001
PubMed
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Leaving a normal-appearing appendix after diagnostic laparoscopy for appendicitis is safe. Long-term follow-up shows minimal complications, supporting this approach in suspected appendicitis cases.

Area of Science:

  • Surgical innovation
  • Diagnostic procedures
  • Gastrointestinal surgery

Background:

  • Diagnostic laparoscopy is a novel tool for evaluating suspected appendicitis.
  • Traditionally, normal-appearing appendices are removed during surgery.
  • The practice of preserving normal appendices is not widely accepted, necessitating long-term outcome evaluation.

Purpose of the Study:

  • To assess the long-term safety and outcomes of preserving a normal-appearing appendix during diagnostic laparoscopy for suspected appendicitis.
  • To determine the rate of subsequent appendicitis or related symptoms in patients who did not have their appendix removed.

Main Methods:

  • A prospective study involving 109 patients undergoing diagnostic laparoscopy for suspected appendicitis.
  • Normal-appearing appendices were intentionally left in place.

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  • Follow-up included a telephone questionnaire after a median of 4.4 years.

    • Main Results:

    • No false-negative laparoscopies were recorded.
    • 15 patients (13.8%) experienced symptoms possibly related to the appendix after a median of 8 months.
    • Only one patient (1%) was diagnosed with appendicitis and underwent appendectomy; 9% reported recurrent right lower quadrant pain.

    Conclusions:

    • Preserving a normal-appearing appendix during diagnostic laparoscopy for suspected appendicitis is a safe strategy.
    • This approach is effective even when no alternative diagnosis is identified during the procedure.
    • The study supports the conservative management of normal appendices in this context.