PROSPECTIVE EVALUATION OF LAPAROSCOPIC APPENDECTOMY IN WOMEN WITH CHRONIC RIGHT LOWER QUADRANT PAIN

Study Objective. To evaluate the feasibility, safety histology, and outcome after appendectomy in women undergoing operative laparoscopy for chronic right lower quadrant pelvic pain. Design. Prospective evaluation since January 1992. Setting. University-affiliate teaching hospital. Patients. Three hundred eighty and 103 patients who underwent operative laparoscopy for chronic pelvic pain and right lower quadrant pain, respectively, over a period of 2 years. Interventions. At laparoscopy, appendiceal pathology (endometriosis, adhesions, fibrosis) was noted, and appendectomy was performed in 38 and 62 of the two groups, respectively. Results, The appendectomy rate was 60% (62/103) and 10% (38/380) in the patients with right lower quadrant pain and chronic pelvic pain, respectively. No intraoperative or postoperative complications were encountered. After appendectomy 97% (60/62) of patients reported complete relief of right lower quadrant pain. Conclusions. Laparoscopic appendectomy is a feasible and safe procedure when performed by experienced surgeons. Appendiceal pathology is prevalent in women with chronic right lower quadrant pain and may be responsible for the pain.