Appendectomy: Outcomes at Suratthani Hospital

Abstract

Background: Appendectomy is commonly encountered by general surgeon. Also quite common are perforated appendicitis and negative appendectomy, which are undesirable outcomes of appendectomy.

Objective: To evaluate the outcomes of appendectomy at Suratthani Hospital and summarize atypical pathological results with discussion of appropriate management.

Material and Methods: A retrospective review was performed of patients who underwent appendectomy for appendicitis form January 2013 to December 2013. Patient demographics, operative characteristic, pathologic diagnosis and surgical outcomes were analyzed.

Result: The overall negative appendectomy rate was 20.5%. Female patients conferred an independent risk for a higher negative appendectomy rate than male (26.4% vs 13.7%; p < 0.001). The overall perforation rate was 19.9% (male 23.2% vs female 16.5%; p = 0.013). Preoperative imaging was associated with rate for perforated appendicitis (p < 0.001) and was not associated with lower negative appendectomy (p = 0.344). Multivariate analysis suggested that WBC count and PMN percentage associated of negative appendectomy. The duration of symptom, the body temperature and PMN percentage of patients with perforated appendicitis were higher than in those without perforation. Only 3.1% of the appendectomy specimens contained other appendiceal pathologies. Neoplastic appendiceal lesion was 0.37%.

Conclusion: Advances in diagnosis and surgical technique may be altering traditionally accepted rate of perforated appendicitis and negative appendectomy. Lower WBC count and lower PMN percentage shown are related to the rate of negative appendectomy. Duration of symptom, body temperature and higher PMN percentage are associated with perforated appendicitis.