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Interval appendicectomy: a retrospective study
1Department of Surgery, Karolinska Institutet at Danderyd Hospital, Sweden.
Objective:
To investigate the complication rate after open interval appendicectomy and compare it with the complication rate after acute appendicectomy.
Design:
Retrospective study.
Setting:
Teaching hospital, Sweden.
Subjects:
38 patients with appendiceal abscess or chronic appendicitis who underwent interval appendicectomy.
Main Outcome Measures:
Operative and histological findings, and postoperative complications after interval appendicectomy.
Results:
The reasons for interval appendicectomy were appendiceal abscess (n = 32, verified by ultrasonography in 25 cases), chronic appendicitis (n = 4), and previous acute appendicitis (n = 2). Five patients underwent drainage of the abscess during the acute episode. The median interval between first symptoms of appendicitis and interval appendicectomy was 3.5 months (range 1.5-15). In two patients (5%) there were no macroscopic or microscopic signs of previous appendicitis and in one patient (61 years old) an adenocarcinoma was found in the base of the appendix. The complication rate was 13% (5/38), which is similar to our morbidity after acute appendicectomy (244/2352, 10%).
Conclusions:
Interval appendicectomy has the same complication rate as acute appendicectomy, and is hardly ever done. We no longer recommend it as a routine and it should be done only for special indications such as persisting complaints that suggest appendicitis.