Early laparoscopic appendectomy for appendicular mass
ABSTRACT The surgical management of acute appendicitis presenting with appendicular mass remains controversial. The aim of this study was to evaluate the role of early laparoscopy and laparoscopic appendectomy (LA) in the management of appendicular mass.
During a 1-year period, 62 patients underwent LA for suspected appendicitis (n = 50), generalized peritonitis (n = 2), and an appendicular mass (n = 10). Another patient who presented with an appendicular mass was found at laparoscopy to have an ileo-ileal intussusception.
All appendectomies were attempted and completed laparoscopically. Postoperative complications occurred in two patients; there were no deaths. None of the patients treated for an appendicular mass developed complications. There was no difference between the patients who underwent LA during the index admission for an appendicular mass and those who had surgery for non-mass-forming appendices with regard to the operative time (median [interquartile range]: 45 [36-60] vs 40 [25-50] min, p = 0.085) and postoperative hospital stay (median [interquartile range]: 2 [1-2] vs [1-2] days, p = 0.1).
Early LA during the index admission of patients with an appendicular mass is feasible and safe, obviates the need for a second hospital admission, and avoids misdiagnoses.
- SourceAvailable from: Arshad Malik[Show abstract] [Hide abstract]
ABSTRACT: Appendicular mass is a well-known complication of acute appendicitis. It is conventionally treated conservatively followed by interval appendectomy. This study aimed to determine the feasibility and safety of an early appendectomy in these cases. Descriptive and comparative. Department of Surgery Liaquat University Hospital, Jamshoro/Hyderabad from March 2003 to December 2007. One hundred and seventy six (176) patients with appendicular mass were included in this study. Patients were conveniently divided into two groups, A and B with equal distribution of cases (88 Patients each), regardless of age and sex. Immediate appendicectomy was performed in group A patients after preliminary investigations, where as patients in group B were initially treated conservatively followed by interval appendicectomy. A total 114 (64.8%) males and 62 (35.2%) females with a mean age of 25.09 years (Range 8-44 years) are included in the study population. Post-operative wound sepsis occurred in 17 (19.31%) patients in group A. Treatment failure, patient compliance, re-admission and overall expenses are main limitations in group B population. Early appendicectomy is a safe and superior option in patients with appendicular mass compared to conventional treatment.Journal of Ayub Medical College, Abbottabad: JAMC 20(1):70-2.
- Pediatric Endosurgery & Innovative Techniques 03/2004; 8(1). DOI:10.1089/109264104773513106