Laparoscopic appendectomy in young female patients: Should we remove the normal-looking appendix?

Objective: This study evaluated whether a significant reduction in unnecessary appendectomies is possible by performing diagnostic laparoscopy before appendectomy in female patients of child-bearing age, leaving behind the normal-looking appendix. Materials and methods: Sixty-one consecutive female patients between the ages of 15 and 45 years with clinical diagnosis of acute appendicitis were studied prospectively. Diagnostic laparoscopy was performed to detect whether the appendix was inflamed. The appendix was then removed and the result of laparoscopic diagnosis was matched with histological diagnosis. Results: Ten out of the 42 laparoscopically diagnosed appendicitis cases had normal appendices on histological examination. Six out of the 19 laparoscopically diagnosed normal appendices had histological evidence of appendicitis. The sensitivity of laparoscopy was 84% and the specificity was 56.5%. Conclusions: Discrepancies existed between laparoscopic appearance and histological examination in acute appendicitis. The appendices of all those with clinically suspected appendicitis should be removed and sent for histological confirmation.