Observational studyWorld journal of surgery2026
Preservation Versus Routine Removal: Morbidity and Long-Term Outcomes Following Diagnostic Laparoscopy Versus Negative Appendectomy-A Regional Multicentre Observational Cohort Study.
Observational study in World journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGuidelines recommend laparoscopic appendectomy (LA) for a macroscopically normal appendix when no pathology is identified during diagnostic laparoscopy (DL) for suspected acute appendicitis (AA). This approach may lead to increased hospitalization, higher costs, and greater morbidity. Whether these guidelines are justified remains debatable.
methodsThis retrospective cohort study included all patients aged > 2 years undergoing DL for suspected AA at four Danish University hospitals from March 2017 to April 2021. Patients undergoing LA despite normal intraoperative findings were compared with patients with normal intraoperative findings undergoing DL only. Sensitivity analyses included patients with incidental intraoperative gynecological or histopathological findings not corresponding with the symptoms. The primary outcome was subsequent DL for suspected AA during follow-up, and the main secondary outcomes were complications within 30 days.
results627 patients underwent DL and 518 underwent LA. Median follow-up was 5.2 years (IQR 4.1-6.1) and 5.7 years (IQR 4.5-6.6), respectively. At a median of 1.7 years (IQR 0.7-3.4), 3.5% (95% CI 2.0-4.9) of the DL group underwent a second DL for suspected AA, with a subsequent 0.96% risk of AA. In the main analyses, no significant differences between the groups were observed for subsequent intra-abdominal surgery, gastrointestinal endoscopy or surgical complications. In sensitivity analyses, surgical complications occurred significantly more frequently after LA (3.7% vs. 1.6% after DL, p = 0.02), mainly driven by a trend toward a higher risk of intra-abdominal bleeding (0.6% vs. 0%, p = 0.056) and intra-abdominal abscess.
conclusionsThe risks of both subsequent DL and AA following initial DL are minimal. The risk of increased surgical complications after LA is low, and the clinical relevance is questionable.
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