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Predictive factors and outcomes of negative appendectomy
1Department of Surgery, Daejin Medical Center Bundang Jesaeng General Hospital, Sungnam-si, Gyeonggi-do, Republic of Korea.
American Journal of Surgery
|October 23, 2016
Summary
Younger patients with normal white blood cell counts and specific computed tomography (CT) findings may have negative appendectomies. Negative appendectomy is associated with more complications than appendectomy for nonperforated appendicitis.
Area of Science:
- Surgical outcomes
- Diagnostic imaging in appendicitis
Background:
- Negative appendectomy, where the appendix is removed but found to be non-inflamed, presents diagnostic challenges.
- Understanding predictive factors for negative appendectomy is crucial for optimizing surgical decision-making and patient outcomes.
Purpose of the Study:
- To identify factors that predict negative appendectomy.
- To evaluate the clinical outcomes associated with negative appendectomy.
Main Methods:
- Retrospective chart review of 4,878 patients who underwent appendectomy between January 2008 and December 2014.
- Analysis of patient demographics, laboratory results, and imaging findings (computed tomography - CT).
Main Results:
- Independent predictive factors for negative appendectomy included younger age (≤15 years), normal white blood cell count, appendix diameter <6 mm on CT, and CT grade <3.
- Negative appendectomy was associated with a statistically significant increase in complications compared to appendectomy for nonperforated appendicitis.
Conclusions:
- In cases of equivocal CT findings for acute appendicitis, consider additional ultrasonography.
- For patients under 15 years with normal white blood cell counts and non-definitive imaging, prolonged symptom monitoring may be preferable to immediate surgery to reduce negative appendectomies.
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