Diagnostic laparoscopy reduces unnecessary appendicectomy in fertile women

Abstract

Objective: To assess the value of laparoscopy in the accurate diagnosis of appendicitis in women of child-bearing age.

Design: Prospective randomised trial.

Setting: University hospital, Kuwait.

Subjects: 100 patients who fulfilled the inclusion criteria between July 1988 and March 1990.

Interventions: 50 patients were randomised to have diagnostic laparoscopy followed by appendicectomy if necessary, and the other 50 to have immediate appendicectomy.

Main outcome measures: Avoidance of unnecessary appendicectomy, length of operating time, and length of stay in hospital.

Results: 19 of 50 patients in the study group did not require appendicectomy (38%). One patient required an emergency operation for an ectopic pregnancy. Of the remaining 30, only 4 of the removed appendixes showed no histological abnormality (13%). There were no complications of laparoscopy.

Conclusion: Laparoscopy is a safe and effective way of diagnosing acute appendicitis and should be used more often.