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Related Experiment Videos

Should the 'normal' appendix be removed at operation for appendicitis?

B Grunewald1, J Keating

  • 1Department of Surgery, Waikato Hospital, Hamilton, New Zealand.

Journal of the Royal College of Surgeons of Edinburgh
|June 1, 1993
PubMed
Summary
This summary is machine-generated.

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Surgeons accurately identified acute appendicitis 91% of the time, but a 26% false reassurance rate for non-inflamed appendices highlights the need for appendix removal even when it appears normal during surgery.

Area of Science:

  • Surgical Pathology
  • Gastrointestinal Surgery

Background:

  • Acute appendicitis is a common surgical emergency.
  • Accurate intraoperative assessment of appendiceal inflammation is crucial for patient management.

Purpose of the Study:

  • To evaluate surgeon's accuracy in diagnosing acute appendicitis intraoperatively.
  • To determine the predictive value of macroscopic assessment versus histological findings.

Main Methods:

  • Prospective study over 6 months.
  • 175 appendices removed and assessed macroscopically by the surgeon.
  • Histological examination for confirmation of inflammation.

Main Results:

  • 131 of 175 appendices (75%) were histologically inflamed.

Related Experiment Videos

  • Surgeon's assessment of inflammation had a 91% positive predictive value.
  • A 26% false reassurance rate occurred when appendices were deemed non-inflamed.

    • Conclusions:

    • Surgeons demonstrate high accuracy in identifying acute appendicitis.
    • A significant false reassurance rate necessitates removing appendices even if appearing normal.
    • Laparoscopic surgery should not change the practice of removing macroscopically normal-appearing appendices to avoid reoperation.