Incidental Appendectomy—Yes or No?A Retrospective Case Study and Review ofthe Literature
[摘要] Objective:A retrospective review of appendectomies performed at the University of Kansas MedicalCenter between January 1, 1989, and January 1, 1994, was conducted. In addition, the literatureevaluating effectiveness of incidental appendectomy in preventing future operation and morbidityfrom appendicitis was reviewed. The results of the two reviews were analyzed to formulate guidelinesfor the appropriateness of performing incidental appendectomy in association with otheroperative 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 removedappendix and operative complications was performed. These results were compared with those ofa systematic review of the literature utilizing a Medline search relating to the subject of incidentalappendix 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 minimalat all ages. Microscopic pathology was found in 25% of the cases.Conclusion:The data from the current survey and literature review support incidental removalof the appendix in the young patient (<35 years old). In patients 35–50 years old the literature iscontroversial, and the patient’s clinical condition and judgment of the operating surgeon shoulddetermine whether incidental appendectomy should be performed. However, routine incidentalappendectomy cannot be justified in patients greater than age 50.
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[效力级别] [学科分类] 妇产科学
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