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Diagnostic laparoscopy reduces unnecessary appendicectomy in fertile women
F A Jadallah1, A A Abdul-Ghani, S Tibblin
1Department of Surgery, Mubarak Al-Kabeer Hospital, Kuwait.
Objective:
To assess the value of laparoscopy in the accurate diagnosis of appendicitis in women of child-bearing age.
Design:
Prospective randomised trial.
Setting:
University hospital, Kuwait.
Subjects:
100 patients who fulfilled the inclusion criteria between July 1988 and March 1990.
Interventions:
50 patients were randomised to have diagnostic laparoscopy followed by appendicectomy if necessary, and the other 50 to have immediate appendicectomy.
Main Outcome Measures:
Avoidance of unnecessary appendicectomy, length of operating time, and length of stay in hospital.
Results:
19 of 50 patients in the study group did not require appendicectomy (38%). One patient required an emergency operation for an ectopic pregnancy. Of the remaining 30, only 4 of the removed appendixes showed no histological abnormality (13%). There were no complications of laparoscopy.
Conclusion:
Laparoscopy is a safe and effective way of diagnosing acute appendicitis and should be used more often.