THE SELECTIVE USE OF FINE CATHETER PERITONEAL CYTOLOGY AND LAPAROSCOPY REDUCES THE UNNECESSARY APPENDICECTOMY RATE |
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| Authors: | R J Baigrie FRCS D Scott-Coombes FRCS Z Saidan FRCS M N Vipond FRCS S Paterson-Brown MPhil FRCS J N Thompson MChir FRCS |
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| Affiliation: | 1. Department of Surgery, The Ealing Hospital, Middlesex;2. Department of Surgery, George Eliot Hospital, Nuneaton;3. Academic Surgical Unit, St Mary's Hospital, London;4. Department of Surgery, Royal Postgraduate Medical School, Hammersmith Hospital, London |
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| Abstract: | The effect of a management protocol incorporating the selective use of fine catheter peritoneal cytology (FCPC) and laparoscopy on the unnecessary appendicectomy rate was studied in adult patients (≥16 years) treated at one district general hospital over an 11 -month period. Appendicectomy was performed on 62 adult patients managed according to this protocol, six (10%) of whom had a histologically normal appendix and no other acute condition requiring surgery. A further 57 patients underwent appendicectomy after standard clinical assessment and investigation without the use of FCPC or laparoscopy. Nineteen (33%) of these patients had a histologically normal appendix removed, with no other acute condition requiring surgical treatment. The selective use of FCPC and laparoscopy significantly reduced the unnecessary appendicectomy rate from 33% to 10% (χ2 = 10.0, P<0.005). The more widespread use of these techniques in patients with suspected appendicitis is therefore recommended. |
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