Laparoscopic accuracy in prediction of appendiceal pathology: oncologic and inflammatory aspects

BackgroundIn the prelaparoscopy era, macroscopically normal appendices were routinely resected. The aim of this study was to evaluate the accuracy of laparoscopy.MethodsA review of 1,899 patients who underwent appendectomy with multivariate analysis was conducted.ResultsLaparoscopic and open approaches had similar false-positive rates, false-negative rates, accuracy, and sensitivity. The study population included 17 false-negative cases (11% of all macroscopically normal appendices). Tumors were found in 1.1% of our study population. Female gender (1.9% vs .5%; odds ratio, 4; 95% confidence interval, 1.5 to 11; P < .005) and appendiceal perforation were independent risk factors for harboring a tumor.ConclusionsIt is suggested that laparoscopy has diagnostic quality similar to that of the open approach. Until randomized trials evaluate the fate of patients who receive false-negative diagnoses, routine appendectomy is recommended. Special attention should be paid to female patients and to patients with perforations, who have a 4-fold increased risk for harboring a tumor.