Rationale of incidental appendectomy

Silvert, Mark; Meares, Edwin M.

doi:10.1016/0090-4295(76)90298-3

Cited by 20 publications

(6 citation statements)

References 25 publications

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“…2,3,5 The incidental discovery of a carcinoid tumor of the appendix can result in a second operation for the patient because right hemicolectomy is considered standard treatment for appendiceal carcinoid tumors greater than 2 cm. 5 In addition, the removal of an occult appendiceal neoplasm is one reason cited for performing an incidental appendectomy as part of urological, 6 gynecological, 7 and colorectal surgical procedures. 8 Identifying carcinoid tumors of the appendix on preoperative CT could therefore aid in presurgical planning.…”

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confidence: 99%

Carcinoid Tumors of the Appendix: Are These Tumors Identifiable Prospectively on Preoperative CT?

Coursey

Nelson

Moreno

et al. 2010

The American Surgeon™

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The purpose of this study was to determine if carcinoid tumors of the appendix were identified prospectively on preoperative CT at our institution during the last decade. A surgical database search performed using the Current Procedural Terminology codes for appendectomy and colectomy yielded 2108 patients who underwent appendectomy or colectomy with removal of the appendix from January 1998 through September 2007. Pathology reports were reviewed to identify patients in whom an appendiceal carcinoid tumor was identified. Preoperative CT reports and images were reviewed. Twenty-three carcinoid tumors (1.1%; 15 women [65.2%], eight men [34.8%]; average age 54 years [range, 23 to 86 years]) were identified. Ten patients underwent preoperative CT. No tumors were identified prospectively on CT. Images were available for rereview for eight patients. Studies were acquired with 16- (n = 7) and four- (n = 1) slice CT scanners. Average reported tumor size was 6.1 mm (range, 1.5 to 15 mm; n = 18). A tip or distal location was reported for all tumors for which a location was given (n = 15). Carcinoid tumors occurred in 1.1 per cent of appendix specimens. These tumors were all less than or 1.5 cm in size. Likely as a result of their small size, none of these tumors was identified prospectively on preoperative CT.

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confidence: 99%

Carcinoid Tumors of the Appendix: Are These Tumors Identifiable Prospectively on Preoperative CT?

Coursey

Nelson

Moreno

et al. 2010

The American Surgeon™

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“…3 Proponents of incidental appendectomy cite technical ease and low morbidity of the procedure, no additional risk in anesthesia, high incidence of disease found in specimens, and elimination of confusion over future conflicting diagnosis. 4 Opponents counter that transecting an organ containing feces in an otherwise clean procedure violates sound surgical principles and increases operative time and morbidity.…”

Section: Discussionmentioning

confidence: 99%

Incidental appendectomy?yes or no? A retrospective case study and review of the literature

Snyder

Selanders

1998

Infect. Dis. Obstet. Gynecol.

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Objective A retrospective review of appendectomies performed at the University of Kansas Medical Center between January 1, 1989, and January 1, 1994, was conducted. In addition, the literature evaluating effectiveness of incidental appendectomy in preventing future operation and morbidity from appendicitis was reviewed. The results of the two reviews were analyzed to formulate guidelines for the appropriateness of performing incidental appendectomy in association with other operative procedures. Method A retrospective review of results of appendectomies performed in 460 patients at the University of Kansas Medical Center with analysis of operative findings, pathology of the removed appendix and operative complications was performed. These results were compared with those of a systematic review of the literature utilizing a Medline search relating to the subject of incidental appendix removal. Results Two hundred sixty‐one incidental appendectomies were performed in this study of 460 patients (60%). The procedure was most commonly performed with total abdominal hysterectomy (56%), followed by oophorectomy (15%) and exploratory laparotomy (11%). Morbidity was minimal at all ages. Microscopic pathology was found in 25% of the cases. Conclusion The data from the current survey and literature review support incidental removal of the appendix in the young patient (<35 years old). In patients 35–50 years old the literature is controversial, and the patient's clinical condition and judgment of the operating surgeon should determine whether incidental appendectomy should be performed. However, routine incidental appendectomy cannot be justified in patients greater than age 50. Infect. Dis. Obstet. Gynecol. 6:30–37, 1998. © 1998 Wiley‐Liss, Inc.

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“…In addition, the ease of resection, low morbidity, and absence of additional anesthetic risks enable incidental appendectomy during non-appendiceal surgery [3][4][5][6][7][8][9][10]. On the other hand, it has been reported that incidental appendectomy contravenes surgical principles by risking contamination, increasing operative time, and morbidity [7,11].…”

Section: Introductionmentioning

confidence: 99%

“…The debate on the advantages and disadvantages of incidental appendectomy has been going for more than a century. There is no right or wrong answer to the question of whether or not to perform incidental appendectomy, only that previous reviews suggested surgeons must carefully consider the following points: 1) epidemiological features and lifetime risk of appendicitis and appendectomy, 2) the function of the appendix and its utility, 3) the morbidity associated with incidental appendectomy, 4) the cost-effectiveness of incidental appendectomy, 5) histological findings after incidental appendectomy [3,4,12]. This review article presents considerations regarding incidental appendectomy.…”

Section: Introductionmentioning

confidence: 99%

The Benefits and Risks of Performing Incidental Appendectomy

Lee

Sul

et al. 2019

J Acute Care Surg

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Acute appendicitis is the most common indication for emergency abdominal surgery worldwide. The risks and benefits of incidental appendectomy during other operations have been debated for over a century. There is no right answer to the question of whether or not to perform incidental appendectomy. Although there are only a few indications where it is explicitly recommended such as in gynecological surgery, malrotation, and Ladd's procedure, incidental appendectomy is cost-effective in selected patient groups, especially in the young, without an increase in morbidity and mortality. In this review, the literature on incidental appendectomy was assessed from several perspectives.

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Rationale of incidental appendectomy

Cited by 20 publications

References 25 publications

Carcinoid Tumors of the Appendix: Are These Tumors Identifiable Prospectively on Preoperative CT?

Carcinoid Tumors of the Appendix: Are These Tumors Identifiable Prospectively on Preoperative CT?

Incidental appendectomy?yes or no? A retrospective case study and review of the literature

The Benefits and Risks of Performing Incidental Appendectomy

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