Selective Appendectomy in Patients Undergoing Minimally Invasive Surgery for Endometriosis: A Retrospective Cohort...

Area of Science:

• Gynecology
• Surgical Pathology

Background:

• Endometriosis is a chronic inflammatory disease affecting pelvic organs and potentially the appendix.
• Appendiceal endometriosis can mimic or coexist with chronic appendicitis, often missed by visual inspection.
• Underdiagnosis of appendiceal involvement leads to suboptimal endometriosis management.

Purpose of the Study:

• Investigate the prevalence and histopathologic spectrum of appendiceal abnormalities in patients with endometriosis.
• Evaluate the safety and postoperative outcomes of selective appendectomy during laparoscopic endometriosis surgery.
• Analyze the association between appendiceal pathology and endometriosis stage.

Main Methods:

• Retrospective cohort study of 236 patients undergoing laparoscopic surgery for endometriosis with selective appendectomy.
• Preoperative risk stratification using the Nezhat Endometriosis Risk Advisor tool and ReceptivaDx testing.
• Intraoperative assessment of the appendix for abnormalities, with removal for significant findings.

Main Results:

• Abnormal appendiceal pathology was identified in 91.53% of patients.
• Histopathology revealed appendiceal endometriosis (14.41%), adhesions (59.32%), and fibrous obliteration (34.75%).
• Appendiceal endometriosis correlated significantly with advanced endometriosis stages (III-IV).

Conclusions:

• Selective appendectomy during endometriosis surgery reveals a high prevalence of appendiceal pathology.
• The appendix may contribute to symptoms even without visible implants, necessitating thorough evaluation.
• Selective appendectomy can aid symptom relief and prevent missed diagnoses in endometriosis management.