Routine Histopathological Evaluation After Appendectomy: Is It Necessary? A Systematic Review.

Area of Science:

• Gastroenterology
• Surgical Pathology
• Clinical Diagnostics

Background:

• Acute appendicitis is a frequent cause of acute abdominal pain.
• Common etiologies include fecaliths and lymphoid hyperplasia, but rare causes like parasitic infections or neoplastic lesions exist.
• The necessity of routine histopathological examination (HPE) for appendectomy specimens is debated due to costs and resource limitations.

Purpose of the Study:

• To systematically review the literature on the diagnostic yield and clinical impact of routine histopathological examination of appendectomy specimens.
• To evaluate the significance of unusual findings in acute appendicitis cases.

Main Methods:

• A systematic literature search was conducted using PubMed, PubMed Central (PMC), and Google Scholar.
• Keywords included "Acute appendicitis" and "routine histopathological examination".
• Fifteen peer-reviewed articles comprising 57,524 cases were selected for review.

Main Results:

• The review identified that while the incidence of unusual pathologies in acute appendicitis is low, it remains significant.
• These infrequent findings can lead to substantial changes in patient management strategies.
• The collective data from 57,524 cases underscore the importance of identifying these rare conditions.

Conclusions:

• Routine histopathological examination of all appendectomy specimens is recommended.
• HPE is crucial for detecting uncommon causes of acute appendicitis, ensuring appropriate patient care.
• Despite potential costs, the clinical significance of identifying unusual pathologies justifies routine HPE.