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Appendectomy: a contemporary appraisal

D A Hale1, M Molloy, R H Pearl

  • 1Quality Assurance Office, Assistant Secretary of Defense (Health Affairs), Washington, D.C., USA.

Annals of Surgery
|March 1, 1997
PubMed
Summary
This summary is machine-generated.

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Appendicitis perforation and negative appendectomy rates remain unchanged despite advances, influenced by factors beyond technology. Complications and mortality are linked to perforation, with higher risks in very young and older patients.

Area of Science:

  • Surgical Practice
  • Gastroenterology
  • Epidemiology

Background:

  • Appendicitis remains a common surgical emergency.
  • Appendectomy is the standard treatment for appendicitis.
  • Understanding current trends in appendicitis and appendectomy is crucial for surgical practice.

Purpose of the Study:

  • To provide a comprehensive overview of appendicitis and appendectomy practices in the 1990s.
  • To analyze patient demographics, diagnostic accuracy, and outcomes.
  • To identify factors influencing perforation and negative appendectomy rates.

Main Methods:

  • A retrospective analysis of 4950 appendectomies performed in Department of Defense hospitals worldwide.
  • Data collected over a 12-month period ending January 31, 1993.

Related Experiment Videos

  • Analysis included patient age, sex, diagnosis, operative factors, and complications.

    • Main Results:

    • The median age of patients was 23 years, with 64% males.
    • Diagnoses included normal appendix (13%), acute appendicitis (66%), and perforated appendicitis (21%).
    • Perforation risk increased in patients ≤8 years and ≥45 years; females had higher normal appendix rates and lower perforation rates. Preoperative temperature and leukocyte count did not reliably differentiate appendicitis from normal appendices. Complications were higher in perforated cases, with a mortality rate of 0.08%.

    Conclusions:

    • Appendicitis perforation and negative appendectomy rates have not changed significantly despite technological advancements.
    • Factors influencing these rates are not solely dependent on intervening technology.
    • Mortality associated with appendicitis has decreased substantially over 50 years.