Published online Jan 27, 2019. doi: 10.4240/wjgs.v11.i1.19
Peer-review started: October 13, 2018
First decision: October 18, 2018
Revised: December 13, 2018
Accepted: December 29, 2018
Article in press: December 30, 2018
Published online: January 27, 2019
Processing time: 107 Days and 16.5 Hours
Incidental appendectomy can be defined as the removal of a clinically normal appendix during another surgical procedure unrelated to appendicitis or other appendicular diseases.
To compare the demographic, biochemical, and histopathological features of the patients who underwent incidental and standard appendectomy.
The demographic, biochemical, and histopathological data of 72 patients (Incidental App group) who underwent incidental appendectomy during living donor hepatectomy at our Liver Transplant Center between June 2009 and December 2016 were compared with data of 288 patients (Acute App group) who underwent appendectomy for presumed acute appendicitis. The Incidental App group was matched at random in a 1:4 ratio with the Acute App group in the same time frame. Appendectomy specimens of both groups were re-evaluated by two experienced pathologists.
Statistically significant differences were found between groups in terms of age (P = 0.044), white blood cell count (P < 0.001), neutrophil (P < 0.001), lymphocyte (P < 0.001), red cell distribution width (P = 0.036), mean corpuscular hemoglobin (P = 0.001), bilirubin (P = 0.002), appendix width (P < 0.001), and presence of acute appendicitis histopathologically (P < 0.001). However, no statistically significant differences were found between groups in terms of gender, platelet, mean platelet volume, mean corpuscular volume, platelet distribution width, appendix length. While the most common histopathological findings in the Incidental App group were normal appendix vermiformis (72.2%), fibrous obliteration (9.7%) and acute appendicitis (6.9%), the most common histopathological findings in the Acute App group were non-perforated acute appendicitis (62.8%), perforated appendicitis (16.7%), lymphoid hyperplasia (8.3%), and appendix vermiformis (6.3%).
Careful inspection of the entire abdominal cavity is useful for patients undergoing major abdominal surgery such as donor hepatectomy. We think that experience is parallel to the surgeon’s foresight, and we should not hesitate to perform incidental appendectomy when necessary
Core tip: Incidental appendectomy is defined as resection of the appendix vermiformis in necessary situations such as a pathologic finding during abdominal operations performed for other reasons. A question remains as to whom incidental appendectomy should be performed. In this study, we compared demographic, biochemical, and histopathological features of the patients who underwent incidental appendectomy during living donor hepatectomy with patients who underwent appendectomy for presumed acute appendicitis.