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Is incidental appendectomy a safe practice?
Abstract:
In an attempt to determine the safety of appendectomy performed as an incidental procedure, the authors reviewed 853 operations (458 hysterectomies and 395 cholecystectomies) performed by five surgeons at one hospital between 1981 and 1984 and compared the results in 35% of the patients who underwent incidental appendectomy with those in the remainder. Factors studied were operative time, postoperative stay, postoperative fever and leukocytosis, the need for intravenous fluids, parenteral analgesia and antibiotics, and infectious complications. Most of these variables differed between individual surgeons, but the addition of incidental appendectomy did not significantly alter any variable for an individual surgeon or for the group as a whole. Incidental appendectomy seems to be a safe practice and one that does not alter the outcome of hysterectomy or cholecystectomy but does protect against subsequent appendicitis.
Insights
Performing incidental appendectomy during hysterectomy or cholecystectomy is safe. This procedure does not negatively impact outcomes and prevents future appendicitis.
Area of Science:
- Surgical outcomes
- Gastrointestinal surgery
- Gynecological surgery
Background:
- Appendectomy is often performed as a primary procedure.
- The safety of incidental appendectomy during other surgeries is less understood.
Purpose of the Study:
- To evaluate the safety and impact of incidental appendectomy.
- To compare outcomes between patients with and without incidental appendectomy.
Main Methods:
- Retrospective review of 853 hysterectomies and cholecystectomies.
- Comparison of outcomes in patients who had incidental appendectomy versus those who did not.
- Analysis of operative time, postoperative stay, fever, leukocytosis, and complications.
Main Results:
- Incidental appendectomy did not significantly alter operative time, postoperative stay, or complication rates.
- Individual surgeon variability was noted, but incidental appendectomy did not add risk.
- No significant difference in postoperative fever, leukocytosis, or need for IV fluids, analgesia, or antibiotics.
Conclusions:
- Incidental appendectomy is a safe surgical practice.
- It does not adversely affect the outcomes of hysterectomy or cholecystectomy.
- It provides protection against the development of subsequent appendicitis.