Negative appendectomy rate during 5 years in Modarres Hospital of Tehran, Iran, and correlation with imaging

Abstract

Appendicitis is the most common emergency surgical admission regardless of the age group. In case of delay in diagnosis, serious complications may occur, needing immediate actions. Complications of acute appendicitis like perforation, peritonitis, and sepsis are to justify massive negative appendectomies. In this study, it has been tried to collect data about negative appendectomy during last 5 years in Modarres hospital, Shahid Beheshti University of Medical sciences, Tehran, Iran, based on demographics and correlation with diagnostic studies before operation. This study is important in terms of economy and health care aspects. Data were collected about all patients appendectomized during 5 years between 2012 and 2017 at Modarres hospital. There were 1454 records, of which 108 records were excluded from the study due to the lack of enough data, interval appendectomy, and clean appendectomy. Finally, end 1346 appendectomies were assessed. There were 275 (20.4%) and 1071 (79.6%) negative appendectomy and suppurative appendicitis, respectively. Preoperative ultrasonography (US) was performed on 753 (56.0%) patients, of which 472 (62.7%) and 281 (37.3%) cases were coordinated with and different from pathologic records, respectively. Preoperative computed tomography (CT) scan was performed for 316 (23.5%) patients, which matched and differed pathologic records in 280 (88.6%) and 36 (11.4%) cases, respectively. Diagnosis of appendicitis should still mainly be based on history, and clinical and laboratory data.

Epidemiological aspects of patients underwent appendectomy in Birjand, Iran, from May 2017 to 2019

“…In the same line, in a study conducted by Rashid-Azar et al (2017), suppurative appendicitis was the most common type that was observed on pathological examination (16). In a study performed by Nabipour in Kerman, Iran, and another research in Modarres Hospital, Tehran, Iran, 33.76% and 79.6% of cases were suffering from suppurative appendicitis, respectively, which were different from our findings in this study (5,15).…”

“…The early diagnosis of this disease is very important and challenging. In case of latency in diagnosis, serious complications, such as perforation, peritonitis, and sepsis may occur, which even might lead to death (3)(4)(5).…”

Pathological Assessment of the Appendix in Appendectomies Performed in Children

“…24 In a study by Malekpour et al on all appendectomy cases during 5 years in a medical center in Tehran, fewer men than women had unnecessary appendix removal surgeries, which is in line with the present study. 41 In a study by Kadi et al, more appendectomies were performed in men and significantly, more women had unnecessary appendix surgeries, which confirms the results of the present study. 42 Other similar studies have emphasized the higher frequency of negative appendectomy cases in women than in men in all age groups.…”

Negative Appendectomy Rates -Current Prospective- A Review

“…Certain countries like Oman in central Asia have reported a negative appendectomy rate of 12.23%. In the East Asia the negative appendectomy rate is about 18.2% as reported in Hong Kong [10][11][12][13].…”