Background: The decision to perform an appendicectomy is traditionally based on clinical findings. This approach, however, results in high rates of negative (non-inflamed) appendicectomies with procedure morbidity associated. Therefore, some consider a negative appendicectomy to be a complication since surgical morbidity could have been avoided. The aim of this study was to evaluate the effect of preoperative imaging on the negative appendicectomy rate in case of suspected appendicitis. Methods: The prospectively collected database for all patients who had undergone acute surgery for a suspected appendicectomy, with or without preoperative imaging, was analysed over a 5-year period. Patient and treatment characteristics, histopathology and postoperative outcomes were recorded and analyzed. Results: A total of 2,070 patients were included, 848 (41%) with preoperative imaging (CT, ultrasound or MRI) and 1,222 (59%) without. Imaged patients were older and suffered from more comorbities. The negative appendicectomy rate was 19.2% (n=235) for the non-imaged patients, and 12.4% (n=105) for imaged patients (p<0.0001). When preoperative imaging was performed, a CT-scan was most accurate to diagnose appendicitis correctly compared to ultrasound (93.6 vs. 30.2%, p<0.0001). Median hospital stay was 3.2 days in the imaged group compared to 2.1 days in the non-imaged group (p=0.171). Conclusion: Preoperative imaging significantly reduces the negative appendicectomy rate. In this time of modern imaging modalities readily available, it is recommended to perform preoperative imaging in case of suspected acute appendicitis to avoid unnecessary surgery and associated morbidity.
| Published in | Journal of Surgery (Volume 9, Issue 1) |
| DOI | 10.11648/j.js.20210901.12 |
| Page(s) | 10-15 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2021. Published by Science Publishing Group |
Acute Appendicitis, Negative Appendicectomy, Emergency Surgery, Preoperative Imaging, Complications
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APA Style
Gavin Nair, James Virgin, Tim Kenyon-Smith, Bev Thomas, Karolina Juszczyk, et al. (2021). Pre-operative Imaging Avoids Unnecessary Surgery for Suspected Acute Appendicitis. Journal of Surgery, 9(1), 10-15. https://doi.org/10.11648/j.js.20210901.12
ACS Style
Gavin Nair; James Virgin; Tim Kenyon-Smith; Bev Thomas; Karolina Juszczyk, et al. Pre-operative Imaging Avoids Unnecessary Surgery for Suspected Acute Appendicitis. J. Surg. 2021, 9(1), 10-15. doi: 10.11648/j.js.20210901.12
AMA Style
Gavin Nair, James Virgin, Tim Kenyon-Smith, Bev Thomas, Karolina Juszczyk, et al. Pre-operative Imaging Avoids Unnecessary Surgery for Suspected Acute Appendicitis. J Surg. 2021;9(1):10-15. doi: 10.11648/j.js.20210901.12
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Download@article{10.11648/j.js.20210901.12,
author = {Gavin Nair and James Virgin and Tim Kenyon-Smith and Bev Thomas and Karolina Juszczyk and Hidde Kroon and Paul Hollington},
title = {Pre-operative Imaging Avoids Unnecessary Surgery for Suspected Acute Appendicitis},
journal = {Journal of Surgery},
volume = {9},
number = {1},
pages = {10-15},
doi = {10.11648/j.js.20210901.12},
url = {https://doi.org/10.11648/j.js.20210901.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210901.12},
abstract = {Background: The decision to perform an appendicectomy is traditionally based on clinical findings. This approach, however, results in high rates of negative (non-inflamed) appendicectomies with procedure morbidity associated. Therefore, some consider a negative appendicectomy to be a complication since surgical morbidity could have been avoided. The aim of this study was to evaluate the effect of preoperative imaging on the negative appendicectomy rate in case of suspected appendicitis. Methods: The prospectively collected database for all patients who had undergone acute surgery for a suspected appendicectomy, with or without preoperative imaging, was analysed over a 5-year period. Patient and treatment characteristics, histopathology and postoperative outcomes were recorded and analyzed. Results: A total of 2,070 patients were included, 848 (41%) with preoperative imaging (CT, ultrasound or MRI) and 1,222 (59%) without. Imaged patients were older and suffered from more comorbities. The negative appendicectomy rate was 19.2% (n=235) for the non-imaged patients, and 12.4% (n=105) for imaged patients (pConclusion: Preoperative imaging significantly reduces the negative appendicectomy rate. In this time of modern imaging modalities readily available, it is recommended to perform preoperative imaging in case of suspected acute appendicitis to avoid unnecessary surgery and associated morbidity.},
year = {2021}
}
TY - JOUR T1 - Pre-operative Imaging Avoids Unnecessary Surgery for Suspected Acute Appendicitis AU - Gavin Nair AU - James Virgin AU - Tim Kenyon-Smith AU - Bev Thomas AU - Karolina Juszczyk AU - Hidde Kroon AU - Paul Hollington Y1 - 2021/01/22 PY - 2021 N1 - https://doi.org/10.11648/j.js.20210901.12 DO - 10.11648/j.js.20210901.12 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 10 EP - 15 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20210901.12 AB - Background: The decision to perform an appendicectomy is traditionally based on clinical findings. This approach, however, results in high rates of negative (non-inflamed) appendicectomies with procedure morbidity associated. Therefore, some consider a negative appendicectomy to be a complication since surgical morbidity could have been avoided. The aim of this study was to evaluate the effect of preoperative imaging on the negative appendicectomy rate in case of suspected appendicitis. Methods: The prospectively collected database for all patients who had undergone acute surgery for a suspected appendicectomy, with or without preoperative imaging, was analysed over a 5-year period. Patient and treatment characteristics, histopathology and postoperative outcomes were recorded and analyzed. Results: A total of 2,070 patients were included, 848 (41%) with preoperative imaging (CT, ultrasound or MRI) and 1,222 (59%) without. Imaged patients were older and suffered from more comorbities. The negative appendicectomy rate was 19.2% (n=235) for the non-imaged patients, and 12.4% (n=105) for imaged patients (pConclusion: Preoperative imaging significantly reduces the negative appendicectomy rate. In this time of modern imaging modalities readily available, it is recommended to perform preoperative imaging in case of suspected acute appendicitis to avoid unnecessary surgery and associated morbidity. VL - 9 IS - 1 ER -
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