Safety of incidental appendectomy

Area of Science:

• Surgical outcomes research
• Trauma surgery
• Evidence-based medicine

Background:

• Conflicting reports exist regarding the safety of incidental appendectomy during laparotomy for trauma.
• Previous retrospective reviews suggested similar morbidity to appendicitis, but their validity is questioned.

Purpose of the Study:

• To prospectively evaluate the morbidity and mortality associated with incidental appendectomy in trauma patients.
• To compare outcomes of incidental appendectomy versus no appendectomy in trauma patients undergoing abdominal exploration.

Main Methods:

• A prospective, randomized trial was conducted on trauma patients with negative abdominal exploration.
• Appendectomy was performed based on an odd/even digit in the hospital number, with the appendix readily accessible.
• Outcomes, including wound infection and intra-abdominal sepsis, were compared between groups.

Main Results:

• No cases of intra-abdominal sepsis occurred in either the appendectomy or control groups.
• Wound infection rates were 1.8% for appendectomy and 3.6% for controls.
• No deaths were reported in the study population.

Conclusions:

• Incidental appendectomy in trauma patients is a relatively safe procedure with low morbidity.
• Prospective, randomized trials provide more reliable data than retrospective reviews for evaluating surgical interventions.