INCIDENTAL APPENDECTOMY

BENEFITS AT THE TIME OF TOTAL ABDOMINAL HYSTERECTOMY

Abstract

Objective: To determine the benefits of incidental appendectomy during abdominal hysterectomy in terms of post-operative
complications and cost of operation. Duration: (5 years) 2003 to 2008. Design: Retrospective study. Methodology: 171patients who did (n:
73) or did not (n: 98) undergo elective incidental appendectomy at the time of uncomplicated total abdominal hysterectomy from 2003 to 2008 at
three different hospitals by a single surgeon. The data was obtained about age, operation time, hospital stay, postoperative complications like
(fever, wound infection, abscess formation, wound collection, wound dehiscence). Post-operative follow up was done for 5 years. Data was
analyzed with chi square test using SPSS 16. Results: Seventy three incidental appendectomies were performed in this study of 171 patients
(43%). The procedure was most commonly performed with total abdominal hysterectomy. Bilateral salpingo oophorectomy was performed in
27 (16%) while unilateral in 13 cases (7.6%). Histopathology was done in 114 cases of uterus (70%), all the ovarian samples (100%), and 14 of
appendixes (19%). Only 06 appendixes out of 14 were reported inflamed (42.8%). Sixteen patients (16.3%) out of remaining 98 patients
reported for appendectomy within 3 to 5 years following TAH. P value <0.05 was considered significant and results of both groups were
compared with mean and P value. Conclusions: The data from current study and review of literature affirms incidental removal of the
appendix. The two groups are comparable to each other in all parameters and perforation. The decision to perform an elective coincidental
appendectomy at the time of an unrelated gynecologic surgical procedure should be based on individual clinical scenarios and patient
characteristics and preferences.