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Implications of removing a normal appendix.

C L Bijnen1, W T Van Den Broek, A B Bijnen

  • 1Department of Surgery, Medical Center Alkmaar, The Netherlands.

Digestive Surgery
|April 11, 2003
PubMed
Summary
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Removing a normal appendix during appendectomy for suspected appendicitis leads to significant complications and costs. Selective use of advanced diagnostic tools is recommended to prevent unnecessary negative appendectomies and associated expenses.

Area of Science:

  • General Surgery
  • Diagnostic Imaging
  • Health Economics

Background:

  • Acute appendicitis diagnosis is challenging, resulting in 15-30% of removed appendices being normal.
  • Negative appendectomies contribute to patient morbidity, mortality, and healthcare costs.

Purpose of the Study:

  • To investigate the morbidity, mortality, and economic impact of removing a normal appendix in patients with suspected appendicitis.

Main Methods:

  • Retrospective study of patients undergoing negative appendectomy (1991-1999).
  • Median follow-up of 4.4 years.
  • Exclusion of elective appendectomies and those for other reasons.

Main Results:

  • 285 patients (67% female) had a normal appendix removed.

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  • Complications occurred in 6% of patients, with 2% requiring reoperation.
  • Mean hospital stay was 4.4 days, with extra costs of EUR 2,712 per negative appendectomy.

    • Conclusions:

    • Removal of a normal appendix incurs substantial complications and financial costs.
    • Consideration of additional diagnostic tools is essential to prevent unnecessary surgeries.
    • Selective use of expensive diagnostic methods, such as diagnostic laparoscopy, is crucial to manage costs effectively.