Related Experiment Video
Updated: Jul 8, 2026
06:46
Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
Published on: January 9, 2026
Randomized clinical trial evaluating elective laparoscopic appendicectomy for chronic right lower-quadrant pain
R M H Roumen1, R P R Groenendijk, C E J Sloots
1Department of Surgery, Stichting Pathologische Anatomie en Medische Microbiologie, Máxima Medisch Centrum, Veldhoven, The Netherlands. r.roumen@mmc.nl
The British Journal of Surgery
|December 29, 2007
Summary
Elective appendicectomy significantly reduces persistent right lower quadrant pain in patients with chronic or recurrent appendicitis. This surgical intervention offers a greater chance of pain improvement compared to observation alone.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Clinical Trials
Background:
- Chronic or recurrent appendicitis can cause persistent right lower quadrant abdominal pain.
- The efficacy of elective appendicectomy for such conditions remains debated.
Purpose of the Study:
- To evaluate the effectiveness of elective laparoscopic appendicectomy in reducing pain.
- To assess the relationship between clinical outcomes and appendiceal histopathology.
Main Methods:
- Single-centre, double-blind, randomized clinical trial.
- Compared laparoscopic appendicectomy versus laparoscopic inspection only.
- Intention-to-treat analysis of pain scores at 6 months post-operation.
Main Results:
- Appendicectomy group showed significantly lower postoperative pain scores (P = 0.005).
- Patients undergoing appendicectomy had a 2.4 times greater chance of pain improvement.
- Number needed to treat was 2.2; no association found between pain scores and histopathology.
Conclusions:
- Elective appendicectomy is an effective treatment for selected patients with persistent or recurrent lower abdominal pain.
- Significant pain reduction can be achieved, irrespective of abnormal histopathology findings.
Related Concept Videos
01:22Appendicitis-I: Introduction
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:19Appendicitis
Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
01:19Abdominal Regions and Quadrants
To promote clear communication, for instance, about the location of a patient's abdominal pain or a suspicious mass, anatomists and clinicians typically use imaginary lines to categorize the abdominopelvic cavity into either four quadrants or nine regions to identify organs in the cavity.
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four quadrants...
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four quadrants...