Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “APPENDECTOMY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

[Retrospective comparative study of 600 appendectomies carried out by laparotomy (Mac Burney) or laparoscopy. A plea for laparoscopy].

The authors report the results of a retrospective study comparing 305 appendectomies by laparotomy (performed in 1988-1989) with 295 appendectomies by laparoscopy (1990-1991). The appendectomy was performed by the "out" technic in 98% of cases of laparoscopy. The two populations are similar. There was no mortality. There was 1% of conversion, 1.4% of incidents and no major accident after laparoscopy. The post-operative course was smooth in 88.2% of cases after laparotomy and in 98% after laparoscopy. A treatment for pain was necessary in 98% of cases after laparotomy and only 45.4% after laparoscopy. The rates of parietal complications, intra-abdominal complications and reinterventions were respectively 10.8%, 1% and 2.4% after laparotomy and 0%, 2.4% and 2.4% after laparoscopy. The mean hospital stay was 7 days after laparotomy and 4 days after laparoscopy. In conclusion, laparoscopy appears superior to laparotomy for performance of an appendectomy: it allows better abdominal exploration, more simple and shorter post-operative course and suppresses parietal complications provided that it is performed by a surgeon with great experience of laparoscopy and respects classic principles of digestive surgery.

Acute Disease↗
PubMedDate not supplied

[Celioscopic appendectomy. Survey of the French Association of Surgery].

When first described in 1983 by Semm, coelioscopic appendectomy had little impact on the surgical community. However, since 1988, the growing widespread use coeliosurgery has lead to renewed interest in the technique. A survey was conducted among the members of the French Association of Surgery. There were 303 responses from 2,437 questionnaires: 195 concerned coelioscopic appendectomy and included a total of 11,086 cases. Most (55.9%) of the surgeons worked in private hospitals and had already gained experience with coelioscopy for gynaecological indications (56.4%). Programmed coelioscopic appendectomies had been performed by 68.3% and peritonitis was the indication in 48.2%. The meso-appendix was treated with coagulation and/or a clip. Peroperative complications were observed in 132 cases (1.19%). Conversion to laparotomy was necessary in 258 cases (2.33%). No deaths were reported. Postoperative complications were reported in 175 cases (1.58%). There were a total of 106 reoperations (0.95%); 43 times by repeat coelioscopy, 59 times by laparotomy and 4 times by Douglas puncture. Discharge was accorded 3.2 (mean) days after the operation. Coelioscopic appendectomy gives results comparable to the laparotomy technique. Its specific advantages are now being assessed in prospective studies.

Appendectomy↗
PubMed1993

Laparoscopic appendectomy in children.

Initially the author began performing laparoscopic appendectomy in May 1988. From January 15, 1991 through June 1, 1992, 51 patients underwent laparoscopic appendectomy at Scottish Rite Children's Medical Center. The ages ranged from 3 to 16 years. There were 28 cases of acute appendicitis, eight of which were perforated. The remaining 23 appendectomies were performed for chronic abdominal pain with incidental appendectomy being performed during diagnostic laparoscopy.

Adolescent↗
PubMed1993

Is a long delay necessary before appendectomy after appendiceal mass formation? A preliminary report.

The standard treatment for an appendiceal mass is conservative therapy followed by appendectomy after 6 to 10 weeks. With the advent of antibiotics designed to prevent the growth of anaerobes, early appendectomy can now be carried out without complication. The authors studied 56 patients with appendiceal mass formation, 26 (group A) treated conventionally and 30 (group B) treated by early appendectomy. In group B, the infection rate was 17%, the mean operating time was 38.7 minutes, the mean hospital stay was 15 days and there was an early return to work. The corresponding parameters for group A were an infection rate of 8%, a mean operating time of 35.2 minutes, a hospital stay of 19.1 days and a late return to work. Furthermore, 15% of the patients in group A had a recurrent acute episode during the waiting period. Overall, early appendectomy appears to be a safe and cost-effective treatment for appendiceal mass formation.

Abscess↗
PubMed1993

[Laparoscopic appendectomy: techniques and results in Switzerland].

We have tried to assess the actual attitude towards laparoscopic appendectomy in Switzerland. An inquiry on preoperative investigations, operative approach and results in cases of suspected appendicitis in 26 surgical Institutions affiliated to the Swiss Association for Laparoscopic and Thoracoscopic Surgery (SALTS) was performed. In a 20 month period a total of 3665 laparoscopic procedures were performed. Appendectomy was attempted in 457 cases in 19 institutions. Conversion to open appendectomy was necessary in 51 cases (11%). Average operative time was 62 minutes. There were 27 postoperative complications (7%). 8 patients (1.9%) needed reoperation. Mean hospital stay was 3.9 days. Opinions of the participating institutions on the actual role of laparoscopic appendectomy (feasibility, advantages or disadvantages) are shown.

Adolescent↗
PubMed1993

The postoperative incidence of small bowel obstruction following standard, open appendectomy and cholecystectomy: a six-year retrospective cohort study at Yale-New Haven Hospital.

The incidence of postoperative small bowel obstruction (SBO) after standard, open appendectomy and cholecystectomy was calculated during a six-year period at a university medical center hospital, which is the larger of two local, community hospitals. A cohort of 567 patients who underwent either a standard, open appendectomy or cholecystectomy from 1 October 1985 through 30 September 1986 was assembled. Of these patients, 182 (32.1%) were readmitted to the hospital prior to 1 October 1991 and thereby received follow-up. The time-related incidence of readmission to the hospital with a specific diagnosis of SBO as estimated by the Kaplan-Meier method was tabulated. This analysis revealed the following incidence rates of postoperative SBO: 10.7% following appendectomy during 64 months of follow-up (n = 41) and 6.4% following cholecystectomy during 67 months (n = 141). The Kaplan-Meier product-limit incidence of postoperative SBO was significantly different for standard appendectomy versus standard cholecystectomy (Breslow-Cox P value < 0.0277). This implies that the anatomical position and/or the likelihood of perioperative infection associated with open, abdominal surgery plays a significant role in subsequent adhesion formation and development of SBO. These data may be compared to laparoscopic techniques in future studies.

Appendectomy↗
PubMed1977

Elective appendectomy with abdominal and pelvic surgery.

A series is presented of 830 patients in whom elective appendectomy was performed at the time of laparotomy for other intraabdominal disease. Special emphasis is given to 490 such procedures among 1042 patients with abdominal hysterectomy, an incidence of 47%. This increases to 57% by exclusion of patients with previous appendectomy. The contraindications to elective appendectomy are discussed, as well as its morbidity, mortality, and complications. The author concludes that an elective appendectomy should be performed with abdominal and pelvic surgery whenever the opportunity is presented, provided that the procedure is not prohibited by the contraindications discussed.

Abdomen↗
PubMed1997

Laparoscopic versus open appendectomy: a prospective randomized trial.

To study comparative results between laparoscopic and open appendectomy, all the patients with suspected acute appendicitis who presented between January 1992 and December 1994 (N = 210) were randomized into two groups: laparoscopic (LA, n = 106) and open appendectomy (OA, n = 104). Patient demographics, pathological findings, operative time, postoperative course, and cost were analyzed. Age, gender, previous laparotomy, intraoperative diagnosis, and perforated appendix rate were comparable between both groups. Mean operative time was longer in the LA group (p < 0.05). Earlier resumption of a regular diet, shorter postoperative stay, and less postoperative analgesia also were observed in the LA group (p < 0.05). Postoperative morbidity and hospital readmissions were similar in both groups (p > 0.05). Higher operative cost was observed in the LA group, but global cost was lower in this group (p < 0.05). Laparoscopic appendectomy shows a more comfortable postoperative course (oral resumption, postoperative stay, and analgesia) over open appendectomy, with similar postoperative morbidity. The LA group showed more operative but less global cost.

Acute Disease↗
PubMed1998

[Negative appendectomy: experience at a university hospital].

BACKGROUND: Acute appendicitis still constitutes a difficult diagnostic problem. AIM: To assess the experience of an University Hospital in the diagnosis of acute appendicitis and to determine the rates of negative appendectomies. PATIENTS AND METHODS: The charts of 1,075 patients operated with the diagnosis of acute appendicitis, between 1993 and 1995, were retrospectively reviewed. All resected appendices were pathologically examined. Those cases in whom pathology did not confirm the clinical diagnosis were considered as a negative appendectomy. RESULTS: There was a 12.2% rate of negative appendectomies (18.9% in women and 6.2% in men). The difference between sexes disappears in patients over 40 years old. In 49% of patients, no abnormality was detected during the laparotomy. The most frequent differential diagnosis were gynecological illnesses or diseases of the colon. DISCUSSION: The rate of negative appendectomies can be reduced with a close clinical observation of patients during their hospitalization and the judicious use of diagnostic laparoscopy.

Adolescent↗
PubMed1998

Fertility and long-term complications four to nine years after appendectomy during pregnancy.

BACKGROUND: The purpose of this study was to determine the long-term outcome after an appendectomy during pregnancy, especially focusing on fertility. METHODS: The Danish National Registry of Patients identified 117 pregnant women who had had an appendectomy during the period 1980 to 1985. One hundred-and-one of these women answered a questionnaire designed to focus on long-term complications, including infertility, during a 4 to 9 year period after the appendectomy. More than a 2-year attempt to conceive was defined as infertility. RESULTS: Of the 101 women 15 with a normal appendix had a new intraperitoneal operation due to different indications. Three of these women had intraperitoneal adhesions. In one patient, adhesions were located on the Fallopian Tube but the location did not influence fertility. Five of the 101 women complained of infertility as defined; all had a normal appendix and none had intraperitoneal surgery during the observation period. Two of these five women conceived later during the observation period; one had confounding female and male infertility factors and two were not examined. CONCLUSIONS: Appendectomy during pregnancy of a normal, inflamed or perforated appendix does not seem to cause clinically significant intraperitoneal adhesions or infertility later in life.

Adult↗
PubMed1998

[Endoscopic appendectomy in gynecology].

From 1987 to 1997 we treated 406 patients with appendicitis. 392 patients were treated by endoscopic appendectomy, 14 patients underwent laparotomy for appendectomy. Among these 406 patients we found 4 patients with primary pelvic inflammatory disease, 18 patients with endometriosis, 15 pregnant patients and 13 patients older than 60 year's. The difficulties during the laparoscopic operation were unimportant and we could keep them under control by laparoscopic. 13 patients developed severe complications during the postoperative period. For this reason we do not perform a prophylactic appendectomy during gynaecological laparoscopies. We present in this paper our results and indications for the endoscopic appendectomy.

Adolescent↗
PubMed1998

[Antibiotic prophylaxis in appendectomy. Often neglected--but necessary!].

For several decades it has been proven that adequate antimicrobial prophylaxis is effective in reducing postoperative septic complications also in appendectomy. The rational for this approach--including laparoscopic procedures--is discussed and national and international recommendations for antibiotic prophylaxis in appendectomy are cited. Unfortunately, in spite of all the evidence, less than 50% of all appendectomies in 1996 in Germany had been carried out under antibiotic cover--with serious consequences for many patients and increased costs for prolonged hospital stay and treatment due to the higher incidence of infectious postoperative complications. Surgeons are encouraged not to neglect facts and benefits concerning the use of appropriate prophylactic antimicrobials in all appendectomies.

Antibiotic Prophylaxis↗
PubMed1998

Appendiceal tumors: retrospective clinicopathologic analysis of appendiceal tumors from 7,970 appendectomies.

BACKGROUND: Appendiceal tumors are rare and often unexpectedly discovered in an acute situation, in which decision-making is difficult. To help define the most appropriate management, a retrospective analysis was undertaken to describe the clinicopathologic behavior of appendiceal tumors, and the literature was reviewed of the management of the different types of appendiceal tumors. METHOD: From a single center, a histopathologic database of 7,970 appendectomies, all appendiceal tumors, were identified and case notes reviewed. Analysis of clinical presentation, histopathology, operation, and outcome is presented. RESULTS: During a 16-year period (7,970 appendectomies), 74 patients (0.9 percent) with appendiceal tumors were identified: 42 carcinoid, 12 benign, and 20 malignant. Acute appendicitis was the most common presentation (49 percent), and 9.5 percent were incidental findings. Primary malignant tumors of the appendix were found in 0.1 percent of all appendectomies. Secondary malignant disease was identified in the appendix of 11 patients, most commonly (55 percent) from patients with primary colorectal disease. There was a high incidence of synchronous and metachronous colorectal cancer in all appendiceal tumors: carcinoids, 10 percent; benign tumors, 33 percent; secondary malignancies, 55 percent; primary malignancies, 89 percent. CONCLUSION: Appendiceal tumors are uncommon and most often present as appendicitis. Most are benign and can be managed by appendectomy, except adenocarcinomas and carcinoids larger than 2 cm, which are most appropriately managed by right hemicolectomy. A suggested management algorithm is provided. Controversy exists over the management of carcinoids 1 to 2 cm in size and adenocarcinoids. All types of appendiceal tumors have a high incidence of synchronous and metachronous colorectal cancer.

Adenocarcinoma↗
PubMed1995

Atrial natriuretic peptide replacement therapy in rats subjected to biatrial appendectomy.

The postoperative fluid retention found in some patients after the Cox maze procedure has been attributed to surgically induced loss of atrial natriuretic peptide. We postulated that exogenous atrial natriuretic peptide could reverse this antidiuresis. A rat model was used to investigate this hypothesis. In group I, the sham group, the atrial appendages were left intact and the animals were then subjected to a fluid challenge equivalent to 1% of the animal's body weight. In group II, after biatrial appendectomy, the animals were subjected to a fluid challenge similar to that in group I. Animals in group III underwent the same protocol as that for group II plus intravenous administration of atriopeptin III at varying concentrations. Urine output and plasma atrial natriuretic peptide levels were significantly decreased after biatrial appendectomies (p < or = 0.01). Urine output returned to control levels after biatrial appendectomies with low-dose atrial natriuretic peptide infusion (0.5 pmol/min = 25.5 pg/min), although circulating atrial natriuretic peptide levels were lower. Urine output and plasma atrial natriuretic peptide levels increased with atrial natriuretic peptide infusions between 0.5 and 50 pmol/min. Heart rate and mean blood pressure did not vary significantly with atrial natriuretic peptide infusions. Thus atrial natriuretic peptide can be used effectively in low doses to induce a diuresis after biatrial appendectomies. Atrial natriuretic peptide may have clinical application after the Cox maze procedure.

Animals↗
PubMed1990

Atrial appendectomy reduces ANF but not sodium excretion in acute vasopressin hypertension.

The present study was designed to determine whether atrial appendectomy would decrease the sodium excretion associated with pressor doses of arginine vasopressin (AVP) infusion in rats by decreasing circulating levels of atrial natriuretic factor (ANF). Ten to 21 days after either sham (n = 9) or bilateral atrial appendectomy (n = 13) AVP (19 ng.kg-1.min-1) was infused for 90 min in anesthetized Sprague-Dawley rats. Atrial appendectomy decreased circulating ANF levels from 469 +/- 70 pg/ml in sham-operated animals to 259 +/- 50 pg/ml (P less than 0.05) in atrial-appendectomized animals after 90 min of AVP infusion. Despite a reduction in circulating levels of ANF, sodium excretion, potassium excretion, and urine flow increased and were not affected by bilateral atrial appendectomy. Glomerular filtration rate and mean arterial pressure significantly increased in both groups of rats. The present study supports non-ANF factors such as increases in renal perfusion pressure and/or glomerular filtration rate as potential mechanisms in AVP-induced natriuresis.

Acute Disease↗
PubMed1994

Effect of bilateral atrial appendectomy on postprandial sodium excretion in conscious monkeys.

We have shown that bilateral atrial appendectomy attenuates the increase in atrial natriuretic factor and sodium excretion that occurs after acute blood volume expansion. These findings suggest that the atrial appendages influence renal sodium excretion. The purpose of the present study was to determine whether atrial appendectomy alters the increase in sodium excretion that occurs postprandially. One to two weeks after surgery, conscious monkeys (Macaca fascicularis) were given a meal through a nasogastric tube. The meal consisted of water (20 ml/kg), sodium (2.5 mmol/kg), carbohydrate (2.65 g/kg), protein (0.68 g/kg), and fat (0.89 g/kg). Postprandial changes in renal function were monitored for 210 min after the meal was started. In the sham animals, urine flow increased from 0.23 +/- 0.04 to 0.55 +/- 0.05 ml/min, sodium excretion increased from 28.6 +/- 7.8 to 84.4 +/- 12.3 mumol/min and fractional sodium excretion increased from 1.35 +/- 0.38% to 3.06 +/- 0.43%. Bilateral atrial appendectomy (ATX) significantly attenuated the renal responses to the meal. Urine flow in the ATX animals increased from 0.19 +/- 0.03 to 0.30 +/- 0.02 ml/min, sodium excretion increased from 26.5 +/- 5.8 to 45.8 +/- 15.2 mumol/min, and fractional sodium excretion increased from 0.99 +/- 0.02% to 1.53 +/- 0.34%. Postprandial changes in renal and systemic hemodynamics were also monitored and were similar in both groups. Plasma levels of atrial natriuretic factor were also similar in both groups and did not increase postprandially. These findings demonstrate that bilateral atrial appendectomy attenuates postprandial-induced increases in sodium excretion by mechanisms that do not involve an increase in atrial natriuretic factor.

Animals↗
PubMed2007

Laparoscopic appendectomy in children: use of the endoloop vs the endostapler.

HYPOTHESIS: Two techniques are used for laparoscopic appendectomy (LA): division of the mesoappendix with the harmonic scalpel and ligation of the appendix with an endoloop (EL), or division of the mesoappendix and appendix with an endostapler (ES). Using an ES is a cost-effective technique that provides an outcome benefit in children who require appendectomy. DESIGN: Case series. SETTING: Academic, tertiary care children's hospital. PATIENTS: Seventy-five children who underwent LA from January 1, 2002, to March 31, 2004. INTERVENTION: Laparoscopic appendectomy. MAIN OUTCOME MEASURES: Age, diagnosis, length of stay, surgical time, total operating room time, complications, and instrumentation costs were compared between the EL and ES groups. RESULTS: There was no significant difference in age, length of stay, perforated, gangrenous, or acute appendicitis diagnoses, or complications between the groups. The surgical time and total operating room time for LA in children in the ES group were significantly shorter than in children in the EL group by 15% and 17%, respectively (P<.05). The disposable equipment costs for LA were $201 per case in the ES group vs $400 per case in the EL group. The mean 14.9-minute increase in total operating room time in children in the EL group resulted in $373 of additional operating room and anesthesia costs. The decreased disposable equipment costs and shorter surgical time of LA in the ES group led to cost savings of $572 per case as compared with children who underwent LA with an EL. CONCLUSIONS: There is no significant difference in outcome between children who undergo LA with an EL or with an ES. However, this study supports the use of the ES for LA as a more cost-effective technique that is associated with reduced surgical time.

Adolescent↗
PubMed1983

Incidental appendectomy in infants and children. Risk v rationale.

Between January 1977 and December 1979 (three years), 642 appendectomies were performed at the Childrens Hospital of Los Angeles. Two hundred seventy-two of the appendectomies were performed incidentally at the time of another abdominal operative procedure. Using known incidence of appendicitis, approximately 54 cases of acute appendicitis may have been obviated. In three patients, would infections developed. Twenty-four of the appendices were histologically normal and 30 were abnormal in a clinically insignificant respect. If incidental appendectomy is appropriate in the age group, it is of more benefit to the pediatric patient because of the frequency of appendicitis in patients under 20 years of age.

Adolescent↗