Implications of removing a normal appendix

被引:37
作者
Bijnen, CL
van den Broek, WT
Bijnen, AB
de Ruiter, P
Gouma, DJ
机构
[1] Med Ctr Alkmaar, Dept Surg, NL-1815 JD Alkmaar, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Surg, NL-1105 AZ Amsterdam, Netherlands
关键词
appendectomy; morbidity; costs; diagnostic tools;
D O I
10.1159/000069386
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background. The diagnosis of acute appendicitis remains difficult, and therefore 15-30% of the removed appendices appear to be normal. The aim of this study is to investigate the morbidity, mortality and costs of removing a normal appendix in patients with suspected appendicitis. Patients and Methods: A retrospective study was performed on patients who underwent a negative appendectomy for suspected appendicitis in the period 1991-1999 with a median follow-up of 4.4 years. Patients who underwent an elective appendectomy or appendectomy for other reasons were excluded. Results: In 285 patients (70% women, 30% men) a normal appendix was removed. In 192 (67%) patients a muscle-splitting incision was performed, in 6 (2%) a median laparotomy, and in 51 (18%) the normal appendix was removed by laparoscopy. In 36 patients (13%) a diagnostic laparoscopy was converted to a muscle-splitting incision. Complications occurred in 16 (6%) patients, in 5 (2%) a reoperation was needed. The mean hospital stay was 4.4 (SE 2.8) days, in case of complication 7.4 (SE 4.2) days. The mean extra hospital costs of a negative appendectomy were EUR 2,712. Conclusion: The removal of a normal appendix has considerable complications and costs. In an attempt to prevent these costs, extra diagnostic tools should be considered. Expensive diagnostic tools as diagnostic laparoscopy should be used selectively in order to not further exceed costs. Copyright (C) 2003 S. Karger AG, Basel.
引用
收藏
页码:115 / 119
页数:5
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