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Influence of CT-measured appendiceal diameter on operation time of laparoscopic appendectomy
Megumu Enjoji1, Naoki Enomoto, Akifumi Kikuchi
1Department of Surgery, Nakano General Hospital, Nakano-ku, Tokyo, Japan.
Abstract:
Laparoscopic appendectomy (LA) is considered as an uncomplicated procedure, so residents are frequently chosen as LA operators. The aim of this study was to identify preoperative factors influencing operation time in LA. We proposed patient selection criteria to help choose an adequately skilled resident for performing LA. The medical records of 117 patients who underwent LA between April 2008 and August 2009 were retrospectively reviewed. Univariate and multivariate analyses were performed to identify factors influencing operation time. Accordingly multivariate analysis indicated that operation time was significantly influenced by C-reactive protein and computed tomography-measured appendiceal diameter. Appendiceal diameter was a better predicting factor for differentiating the longer and shorter operation time groups. The cut-off value for appendiceal diameter was 12 mm. We concluded that preoperative computed tomography findings of appendiceal diameter of more than 12 mm in patients suggested that LA would be technically challenging for the less experienced resident.
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