ArticleSurgical endoscopy2009
Routine diagnostic laparoscopy reduces the rate of unnecessary appendicectomies in young women.
Article in Surgical endoscopy, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 29 citations in OpenAlex.
- Is it possible to predict the severity of acute appendicitis? Reliability of predictive models based on easily available blood variables.World journal of emergency surgery : WJES · 2023Article
- Preoperative C-reactive protein predicts the severity and likelihood of complications following appendicectomy.Annals of the Royal College of Surgeons of England · 2014Article
- Omental Torsion: An Unusual Cause of Right Iliac Fossa Pain and Role of Laparoscopic Management.Gastroenterology research · 2013Article
- Torsion of an abdominal-wall pedunculated lipoma: a rare differential diagnosis for right iliac fossa pain.Case reports in surgery · 2013Article
- Appendectomy in Germany-an analysis of a nationwide survey 2011/2012.International journal of colorectal disease · 2013Article
- Laparoscopic appendectomy for acute appendicitis is more favorable for patients with comorbidities, the elderly, and those with complicated appendicitis: a nationwide population-based study.Surgical endoscopy · 2011Article
- Ergonomics and Technical Aspects of Minimal Access Surgery in Acute Surgery.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2010Article
- Surgery: Laparoscopy for suspected appendicitis.Nature reviews. Gastroenterology & hepatology · 2009Article
- Clinical outcomes of laparoscopic versus open appendectomy.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe reported negative appendicectomy rate for young women remains high. This high rate of unnecessary appendicectomies has morbidity and high cost. Consensus European Association of Endoscopic Surgeons (EAES) guidelines have emphasised the value of routine laparoscopy as a diagnostic tool in young women. The objective of this study is to investigate the role of routine laparoscopy in the diagnosis of suspected appendicitis in young women.
methodsThe details of young female patients who have had an appendicectomy with or without laparoscopy between 1980 and 2005 were obtained. The histopathological reports pertaining to the episode of appendicectomy were manually searched. Three periods were identified for comparison. The first period was between 1980 and 1990 when diagnostic laparoscopy was not practised in the emergency setting. The second period was between 1991 and 1999 when diagnostic laparoscopy was used selectively. The third period was between 2000 and 2005 when diagnostic laparoscopy was used routinely to investigate female patients presenting with acute right iliac fossa pain.
resultsSelective laparoscopy reduced the rate of negative appendicectomy rate from 37% to 31% (ns). By contrast, routine laparoscopy reduced the negative appendicectomy rate to 5% (p < 0.005). Additionally, considering the ratios of all appendectomies to normal appendices, an average of one in three appendices excised was normal before the era of laparoscopy. The selective use of laparoscopy did not significantly alter this ratio (ns). By contrast routine use of laparoscopy has altered the ratio to 1 in 20 appendices removed to be normal (p < 0.001).
conclusionIn young females, diagnostic laparoscopy used selectively reduces the rate of negative appendicectomy but not significantly. However, when used routinely, laparoscopy significantly reduces the rate of negative appendicectomy. Diagnostic laparoscopy should be used routinely for all young females presenting with right iliac fossa pain sufficiently severe to warrant surgical exploration.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.