Appendicitis Research Today is a free monthly online journal that collates and summarizes the latest research about Appendicitis, including details on symptoms, surgery, causes, treatment.

Laparoscopic Appendectomies: Retrospective Study of 2074 Cases.

Champault A, Polliand C, Mendes da Costa P, Champault G

*Department of Digestive Surgery, Jean Verdier University Hospital, Bondy, France †Department of Digestive and Laparoscopic Surgery, C.H.U. Brugmann, ULB, Brussels, Belgium.

PURPOSE: To determine feasibility and safety of laparoscopic appendectomy (LA). PATIENTS: From January 1991 to June 2006, 2209 consecutive patients underwent appendectomy; for 2074 patients, appendectomy was performed laparoscopically. One thousand and fifty (53%) were women; mean age was 30.8 (11 to 96) years. Mean body mass index was 23.6 (18 to 58 kg/m). Mean American Society of Anesthesiology score was 1.3 (I to III). RESULTS: Mean operating time was 52 minutes (15 to 200). Conversion to open appendectomy occurred for 84 patients (3.6%) mainly for acute or generalized peritonitis, abscess, or adhesion. Mean hospital stay was 3.75 (1 to 27) days. There was no mortality. Morbidity occurred in 4.5% of the patients: parietal (1.15%), peritoneal complications (1.1%), and others (2.25%). Additional interventions were required for 30 patients (1.5%) primarily for residual abscesses. In this study, 10.9% (n=226) of the specimens were considered normal by the pathologist. In 3.9% (77 cases), laparoscopy did not find any cause for nonspecific abdominal pain. In these cases, appendix was not removed. CONCLUSIONS: LA is technically feasible and safe. Diagnostic laparoscopy is recommended in cases suspicious for acute appendicitis. Laparoscopy permits a complete exploration of the abdominal cavity, helps to localize the appendix, allows for the eliminations of other diagnoses when the appendix is normal, and to facilitate a better peritoneal lavage in case of peritonitis. It is recommended to perform LA routinely in young women and obese. Although advantages of LA still need to be evaluated, in view of the excellent results, we have decided to perform it routinely. We also recommend not removing macroscopically normal appendices discovered during diagnostic laparoscopy for abdominal pain of unexplained origin.

Published 25 April 2008 in Surg Laparosc Endosc Percutan Tech, 18(2): 168-172.
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Articles on Appendicitis published 25 April 2008:

Stress-related mucosal disease in childhood appendicitis.   Pediatr Surg Int.

Stress-related mucosal disease (SRMD) is known to occur in critically ill patients both in the adult and paediatric population. Acute appendicitis is the most common surgical emergency in childhood and can precipitate SRMD. This possibility should be kept in mind, particularly in prolonged, complicated episodes. Although clinical complications of SRMD are rare, they may be highly significant in terms of haemorrhage or perforation and result in considerable morbidity or mortality. We provide a ... [Abstract] [Full-text]

Concordance of interrater assessments of surgical methods to achieve source control of intra-abdominal infections.   Am J Surg.

BACKGROUND: Source control, any procedure used to control the source of a major infection, is critical to the resolution of intra-abdominal infections. We sought to characterize whether surgeons agree on methods of source control for patients who had persistent infection despite initial surgical treatment and antimicrobials. METHODS: We analyzed source control decisions in a trial comparing tigecycline with imipenem in the treatment of intra-abdominal infections for patients who were clinical ... [Abstract] [Full-text]

Articles on Appendicitis published 22 April 2008:

Laparoscopic surgery: does it increase the probability of atrial and ventricular arrhythmias in children?   Surg Laparosc Endosc Percutan Tech, 18(2): 173-7.

PURPOSE: Despite the minor physiologic changes those occur during laparoscopic procedures, pneumoperitoneum with CO2 insufflation may induce alterations in electrocardiographic (ECG) variables, which may predict severe atrial and ventricular arrhythmias. This study aims to assess QT dispersion (QTD) and P wave dispersion (PWD) changes in children who have undergone laparoscopic appendectomy. PATIENTS AND METHODS: Sixteen patients (12 males and 4 females) who had preoperative diagnosis of ... [Abstract] [Full-text]

Appendicitis after appendectomy.   Arch Surg, 143(4): 413-5.

Appendectomy is one of the most common surgical procedures performed in the United States. Residual appendiceal tissue left at the time of appendectomy may predispose to the rare development of stump appendicitis. Patients typically are seen with signs and symptoms similar to appendicitis; however, the diagnosis is often delayed owing to the low index of suspicion, which may result in perforation. We describe a patient with recurrent appendicitis after previous appendectomy and review the ... [Abstract] [Full-text]

Cecal diverticulitis mimicking acute Appendicitis: a report of 4 cases.   World J Emerg Surg, 3(1): 16.

ABSTRACT: Diverticulum of the cecum is a rare, benign, generally asymptomatic lesion that manifests itself only following inflammatory or hemorrhagic complications . Most patients with inflammation of a solitary diverticulum of the cecum present with abdominal pain that is indistinguishable from acute appendicitis. The optimal management of this condition is still controversial, ranging from conservative antibiotic treatment to aggressive resection. We describe four cases that presented with ... [Abstract] [Full-text]

Articles on Appendicitis published 17 April 2008:

Impact of body mass index and tobacco smoking on outcome after open appendicectomy.   Br J Surg.

BACKGROUND:: The effect of body mass index (BMI) and smoking on the risk of perforated appendix and postoperative complications in patients undergoing open appendicectomy for acute appendicitis was studied. METHODS:: Record linkage was used to identify 6676 male construction workers who underwent open appendicectomy for acute appendicitis between 1971 and 2004. Multivariable binomial logistic regression analyses were performed. RESULTS:: After adjustment for age, calendar period and BMI, ... [Abstract] [Full-text]

Articles on Appendicitis published 16 April 2008:

Coliform pyosalpinx as a rare complication of appendicectomy: a case report and review of the literature on best practice.   J Med Case Reports, 2: 97.

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Surviving 27 weeks fetus expelled out of the ruptured rudimentary horn and detected a month later as a secondary abdominal pregnancy.   J Obstet Gynaecol Res, 34(2): 247-51.

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