Blande Appendix: Inversions-?Appendektomie? oder ?Amputations?-Appendektomie?

Abstract

Normal or scarred appendixes may be removed by amputation or inversion. Inversion is appealing for its high degree of asepsis, but criticized for the possibility of organ retention with consecutive invagination. The risks and advantages of amputation appear to be exactly the opposite. For objective comparison, a prospective study was undertaken, using both procedures in 400 cases of solitary and 40 cases of complementary appendectomies at a random number key. Wound infection was observed in 0.5% following inversion, in 8% following amputation as a solitary procedure. Both methods were equally followed by wound infections which performed as complementary procedures. However, inversion was free of enterogenous infection in all cases. Technical precautions were taken to facilitate sloughing of inverted appendixes. No clinical symptoms indicating retention or correlated complications were observed.

Surgical Inversion: The Safer Way to Operate a Noninflammatory Appendix

“…Rectal hemorrhage following slough of an inverted appendix is a rare incidence [17,18] and known to occur also after excision appendectomy [24]. Hence, it cannot be considered as specific procedural problem.…”

“…On the other hand, a retrospective analysis of late post operative obstructions reveals a disproportionately high incidence of preceding appendectomies, 41% [18] and 43 % [ 1 ], respectively.…”