Should We Perform Incidental Appendectomy in Trauma Patients Undergoing Laparotomy?

Area of Science:

• Trauma Surgery
• Surgical Oncology
• Gastrointestinal Surgery

Background:

• Incidental appendectomy (IA) may prevent future appendicitis in patients undergoing abdominal surgery.
• Laparotomy for major abdominal trauma increases the risk of adhesions and future operations.
• IA during trauma laparotomy could potentially reduce these risks.

Purpose of the Study:

• To evaluate the safety and outcomes of incidental appendectomy in patients undergoing laparotomy for abdominal trauma.

Main Methods:

• Retrospective review of patients who underwent incidental appendectomy during laparotomy for abdominal trauma.
• Data collected from a Level 1 trauma center between January 2010 and June 2020.
• Analysis of patient demographics, injury types, indications for IA, and complications.

Main Results:

• Twenty-three patients underwent incidental appendectomy.
• Patients were typically young males (33.7 ± 18.9 years, 87% male) with penetrating (12) or blunt (11) injuries.
• The primary indication was no intra-operative abnormality (13 patients); other reasons included fecalith (6) or appendiceal trauma (3).
• Only one patient (4.3%) experienced an appendiceal stump leak, indicating a low complication rate.

Conclusions:

• Incidental appendectomy during trauma laparotomy is associated with a low rate of complications.
• This procedure may be a beneficial option for trauma patients to prevent subsequent appendicitis.
• Further research could explore long-term outcomes and cost-effectiveness.