Predictive factors and outcomes of negative appendectomy

- The main contribution of our article is that negative appendectomy is not harmless to patients as it shows higher complication rates compared with appendectomy for nonperforated appendicitis.
- When computed tomography findings are equivocal, in deciding to operate for acute appendicitis, additional ultrasonography can be performed.
- Furthermore, if the patient is younger than 15 years and the white blood cell count is normal, it is recommended to monitor changes in symptoms a little longer rather than operating hastily.

BackgroundThe aim of this study was to assess predictive factors for negative appendectomy and to evaluate the outcomes of negative appendectomy.MethodsA retrospective chart review of 4,878 patients who underwent appendectomy at our institution from January 2008 to December 2014 was performed.ResultsYounger age (≤15 years), normal white blood cell count, appendix diameter of less than 6 mm on computed tomography (CT), and CT grade less than 3 were found to be independent predictive factors for negative appendectomy. When complications were investigated according to the results of pathologic diagnosis, negative appendectomy had more complications than appendectomy for nonperforated appendicitis, and this was statistically significant.ConclusionsWhen CT findings are equivocal, in deciding to operate for acute appendicitis, additional ultrasonography can be performed. Furthermore, if the patient is younger than 15 years and the white blood cell count is normal, it is recommended to monitor changes in symptoms a little longer rather than operating hastily.