The safety of incidental appendectomy at the time of abdominal hysterectomy

Salom, Emery; Schey, Dana; Peñalver, Manuel; Gómez-Marı́n, Orlando; Lambrou, Nicholas C; Almeida, Zoyla; Méndez, Luis

doi:10.1016/s0002-9378(03)00936-0

Cited by 45 publications

(26 citation statements)

References 12 publications

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“…Thus, macroscopic assessment of appendiceal pathology during benign gynecological surgery appears to correspond with histopathological findings. Appendectomy may be performed during gynecological surgery with minimal morbidity [4]. Therefore, we concur with the recommendation made by Lynch et al [7] to inspect the appendix during gynecological surgery on a routine basis and to perform an appendectomy if the appendix appears abnormal.…”

Section: Discussionsupporting

confidence: 85%

“…Although the practice of prophylactic appendectomy in gynecological surgery remains controversial, Salom et al [4] discovered significant appendiceal pathology in 31% of the women who underwent incidental appendectomy during benign gynecological surgery [4]. Furthermore, in a review of 532 women who underwent incidental appendectomy during gynecological surgery, Taniguchi and Kilkenny [5] found that acute inflammation was diagnosed by a pathologist in 10.5% of cases: 9.6% catarrhal appendicitis and 0.9% subacute and early acute appendicitis.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is considerable research on appendectomy performed in the setting of chronic pelvic pain [2,3] as well as prophylactic or incidental appendectomy at the time of gynecological surgery [4,5,6,7], we have failed to find literature addressing the intraoperative findings that incite appendectomy during benign gynecological procedures and the resultant appendiceal pathology. Therefore, we were interested in determining which intraoperative findings resulted in appendectomy during gynecological surgery and if macroscopic findings at the time of surgery corresponded with appendiceal histopathology.…”

Section: Introductionmentioning

confidence: 99%

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Appendectomy in the Gynecological Setting: Intraoperative Findings and Corresponding Histopathology

Shavell¹,

Mahdi²,

Awonuga³

et al. 2010

Gynecol Obstet Invest

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Background/Aims: To evaluate the intraoperative findings and corresponding histopathology associated with appendectomies performed during benign gynecological surgery. Methods: Retrospective case series. Results: Twenty-two appendectomies were performed from 2002 through 2008 at Hutzel Women’s Hospital due to intraoperative findings of inflammation or erythema (n = 8), periappendiceal adhesions (n = 5), injury to the appendix or mesoappendix (n = 2), fecalith (n = 2), dilation of the appendix (n = 1), adnexal mass involving the appendix (n = 1), and suspected lipoma (n = 1). Final pathology was consistent with significant findings such as acute inflammation, periappendicitis, and adhesions or endometriosis involving the appendix in 68.2% of cases. Conclusion: In the benign gynecological setting, appendectomies were primarily performed due to inflammation or erythema. In the majority of cases, significant appendiceal pathology was confirmed.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Appendectomy in the Gynecological Setting: Intraoperative Findings and Corresponding Histopathology

Shavell¹,

Mahdi²,

Awonuga³

et al. 2010

Gynecol Obstet Invest

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“…Patients' gender: Stone et al [55] advised against the removal of an asymptomatic MD in adult women. For some time MD resections were actually almost as common as elective appendectomies during gynecologic procedures [8,56], but no more justifiable.…”

Section: Discussionmentioning

confidence: 99%

The truth behind the "rule of twos" the Meckel diverticulum revised

2007

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Zusammenfassung. Grundlagen: Auch der Aufschwung laparoskopischer Techniken in der Abdominalchirurgie hat am grundsä tzlichen Problem nach der Diagnose und Therapie des Meckel-Divertikels (MD) nichts geä ndert.Methodik: Große Ü bersichtsarbeiten und Serien insbesondere aus den letzten zehn Jahren und mit besonderer Berü cksichtigung erwachsener Patienten wurden fü r die Analyse heran gezogen.Ergebnisse: Bei 1116 Resektionen von asymptomatischen MD betrug die Komplikationsrate 3,67% und die Letalitä t 0,18%; bei symptomatischer Divertikeln (502 Eingriffe) 9,56% und 1,99%. Der Unterschied ist statistisch signifikant. Aus dieser Tatsache und den aus der Literatur erhobenen Risikofaktoren leiten wir einen Algorithmus zum Verhalten bei asymptomatischem MD ab.Schlussfolgerungen: Aktuelle Studien zeigen, dass die Entfernung eines zufä llig aufgefundenen MD mit einer Komplikationsrate und Letalitä t erfolgen kann, die weit unter den fü r symptomatische Divertikeloperationen liegt. Wir empfehlen daher die Suche und Entfernung des MD in den meisten Fä llen, in denen der Eingriff chirurgisch vertretbar ist.Schlü sselwö rter: Meckel-Divertikel, Laparoskopie, Komplikationen, Kinderchirurgie, Bauchchirurgie.Summary. Background: The diagnosis and treatment of the Meckel diverticulum (MD) continue to fascinate abdominal surgeons. The ''disease of the twos'' must be reconsidered in the context of emerging laparoscopic techniques.Methods: A meta-analysis of recent large studies reporting MD especially in adults was undertaken.Results: The morbidity and mortality of 1116 incidental resections were 3.67 and 0.18%, respectively, while after surgery for 502 symptomatic diverticula, a morbidity of 9.56% and a mortality of 1.99% were found. The difference is highly significant. From recent data in the literature we have generated an algorithm for the approach towards the incidentally detected MD.Conclusions: Although the management of asymptomatic diverticula is still controversial, new data show that incidental diverticulectomy can be performed with morbidity and mortality rates far below the rates for symptomatic cases. This led us to recommend removal of the asymptomatic MD when surgically justifiable.

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“…Moreover, since incidental appendicectomy cases are likely to reveal hidden pathologies [6,7], they are liable to be positively identifiable when involved. In all probability, the more the collections which are made, the more the positive knowledge that will accrue [8]. And this is where archival radiographs can be mustered strong worldwide.…”

Section: Hypothesismentioning

confidence: 99%

Global imaging will widen epidemiologic knowledge of appendicitis by perceiving the dilated crypts in archival collections worldwide

Onuigbo¹

2017

Glob Imaging Insights

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Appendicitis is a worldwide problem with a fascinating epidemiology which deserves researches. In the 1960s, such much needed research was directed to expanding its boundaries. This resulted in promoting its acute "limited" variety. It was in this context that the crypt abscess within it came into prominence. Accordingly, what can follow when these abscesses resolve? It is necessarily the formation of determinable ovoid spaces. Since these can be recognized with biomedical graphics, it is hypothesized that archival films, which abound all over the world, will promote the epidemiologic study of this vestigial organ. HypothesisWorldwide problems concern the epidemiology of appendicitis undoubtedly [1,2]. In order to improve on a better knowledge of it, Howie [3] stressed the importance of including the "limited" form of it in classifications! However, as he put it, "I have disregarded solitary crypt abscesses which do not show invasion of the adjacent stroma by polymorphonuclear leucocytes."

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The safety of incidental appendectomy at the time of abdominal hysterectomy

Cited by 45 publications

References 12 publications

Appendectomy in the Gynecological Setting: Intraoperative Findings and Corresponding Histopathology

Appendectomy in the Gynecological Setting: Intraoperative Findings and Corresponding Histopathology

The truth behind the "rule of twos" the Meckel diverticulum revised

Global imaging will widen epidemiologic knowledge of appendicitis by perceiving the dilated crypts in archival collections worldwide

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