TY - JOUR
T1 - Laparoscopic accuracy in prediction of appendiceal pathology
T2 - Oncologic and inflammatory aspects
AU - Sadot, Eran
AU - Keidar, Andrei
AU - Shapiro, Ron
AU - Wasserberg, Nir
PY - 2013/11/1
Y1 - 2013/11/1
N2 - Background In the prelaparoscopy era, macroscopically normal appendices were routinely resected. The aim of this study was to evaluate the accuracy of laparoscopy. Methods A review of 1,899 patients who underwent appendectomy with multivariate analysis was conducted. Results Laparoscopic and open approaches had similar false-positive rates, false-negative rates, accuracy, and sensitivity. The study population included 17 false-negative cases (11% of all macroscopically normal appendices). Tumors were found in 1.1% of our study population. Female gender (1.9% vs.5%; odds ratio, 4; 95% confidence interval, 1.5 to 11; P <.005) and appendiceal perforation were independent risk factors for harboring a tumor. Conclusions It is suggested that laparoscopy has diagnostic quality similar to that of the open approach. Until randomized trials evaluate the fate of patients who receive false-negative diagnoses, routine appendectomy is recommended. Special attention should be paid to female patients and to patients with perforations, who have a 4-fold increased risk for harboring a tumor.
AB - Background In the prelaparoscopy era, macroscopically normal appendices were routinely resected. The aim of this study was to evaluate the accuracy of laparoscopy. Methods A review of 1,899 patients who underwent appendectomy with multivariate analysis was conducted. Results Laparoscopic and open approaches had similar false-positive rates, false-negative rates, accuracy, and sensitivity. The study population included 17 false-negative cases (11% of all macroscopically normal appendices). Tumors were found in 1.1% of our study population. Female gender (1.9% vs.5%; odds ratio, 4; 95% confidence interval, 1.5 to 11; P <.005) and appendiceal perforation were independent risk factors for harboring a tumor. Conclusions It is suggested that laparoscopy has diagnostic quality similar to that of the open approach. Until randomized trials evaluate the fate of patients who receive false-negative diagnoses, routine appendectomy is recommended. Special attention should be paid to female patients and to patients with perforations, who have a 4-fold increased risk for harboring a tumor.
KW - Appendectomy
KW - Appendicitis
KW - Laparoscopy
KW - Macroscopic
KW - Tumor
UR - http://www.scopus.com/inward/record.url?scp=84886727030&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2013.05.002
DO - 10.1016/j.amjsurg.2013.05.002
M3 - Article
C2 - 24016703
AN - SCOPUS:84886727030
VL - 206
SP - 805
EP - 809
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 5
ER -