Appendectomy Flashcards
The gold standard for surgical treatment of acute appendicitis
remains open appendectomy as described by McBurney
A meta analysis of 27 studies involving 2,532 patients with gangrenous or perforating appendicitis concluded that the risk of surgical site infection was
no higher with primary closure than with delayed primary closure
Most common cause of an acute surgical abdomen in the US
acute appendicitis
The incidence of histologically normal appendix in patients with clinical signs and symptoms of acute appendicitis
ranges from 8 to 41%
Neoplastic lesions of the appendix are found is as manu as
5% of specimens obtained with routine appendectomy for acute appendicitis - most are benign
Benign neoplasms of the appendix include:
mucosal hyperplasia or metaplasia, leiomyomas, neuromas, lipomas, angiomas, and other rare lesions
Malignant tumors of the appendix primarily consist of
carcinoids (80%) > adenocarcinoma - 0.5% of all GI malignancies
Incidence of malignancy in the appendix is
1.35%
Metastasis to the appendix is
rare
Carcinoid tumors are found in
0.5% of all appendiceal specimens
Recommended treatment for primary adenocarcinoma of the appendix
right hemicolectomy
The appendix is frequently involved in Crohn disease and ulcerative colitis
25% and 50% of cases, respectively
Conversion rate from laparoscopic to open appendectomy
10% (range, 0 to 23%)
Higher incidence of intra-abdominal abscess formation is seen after
laparoscopic appendectomy
Higher incidence of surgical site infection is seen after
open appendectomy
