Evaluation of Diagnostic Laparoscopy with laparoscopic Appendectomy in Females with Acute Right Lower Quadrant Pain, a Multicenter Study

Aref, Nesreen; Al Saeed, Mohamed; Al-Jiffry, Bilal O; Al-Mourgi, Majed; Younes, Alaa; Abdel-Rahman, Tamer; Badr, Samir; Al-Sawat, Abdullah

doi:10.21608/ejhm.2019.23112

Evaluation of Diagnostic Laparoscopy with laparoscopic Appendectomy in Females with Acute Right Lower Quadrant Pain, a Multicenter Study

Document Type : Original Article

Authors

¹ Department of Obstetrics and Gynecology, Taif University, Saudi Arabia

² Department of Surgery, Taif University, Saudi Arabia

³ General Organization of Teaching Hospitals and Institutes (Benha)

⁴ General Organization of Teaching Hospitals and Institutes (Damanhur)

10.21608/ejhm.2019.23112

Abstract

Background and aim of the study: Diagnostic laparoscopy is the gold standard for diagnosis of acute right lower abdominal pain (ARLQP) in females especially in child bearing age and its value to perform laparoscopic appendectomy in such complex conditions is gaining acceptance amongst surgeons. The aim of this multicenter study was to evaluate the values of diagnostic laparoscopy with laparoscopic appendectomy in female patients with acute right lower quadrant abdominal pain.
Material and method: This multicenter prospective study enrolled 253 female patients who presented with acute right lower quadrant pain to Taif tertiary hospitals (Saudi Arabia) and performed laparoscopic appendectomy during diagnostic laparoscopy from May 2012 to April 2017.
Results: The study included 253females with mean age of 31.1±6.8 years. Diagnostic laparoscopy with laparoscopic appendectomy was done for all of them. Acute appendicitis was the most common cause of ARLQP (22.1%). 10.5% of macroscopically normal appendices had acute appendicitis. Mean total operating time was 65.6±14.7 and for the appendectomy portion of the operation it was 14.3±2.8 minutes when the appendix was grossly inflamed and it was 11.8±2.3 minutes when the appendix was apparently normal (incidental appendectomy).The mean hospital stay for grossly inflamed appendix was 24.8±5.5 hours, of incidental appendectomy without associated pelvic pathology was 22.3±5.2 hours increased to 72.4±16.5 hours if other pelvic pathology was managed. Post operative complications occurred in 4%. No operative or early postoperative mortality was recorded.
Conclusion: This study supports the value of diagnostic laparoscopy in diagnosis and management of females with ARLQP and verified that acute appendicitis is the most common cause in such females. The study proved also that laparoscopic appendectomy is safe, effective, quick in addition; the study verified the role of incidental appendectomy in prevention of reoperation for future appendicitis.

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