Does Appendectomy at the Time of Laparoscopic Gynecologic Surgery Increase Risk of Complications?
BACKGROUND AND PURPOSE:
O’Brien (Obstetrics & Gynecology, 2022) assessed whether concomitant appendectomy in patients who undergo laparoscopic surgery for benign gynecologic indications is associated with increased rates of complications
Retrospective cohort study
18 to 51 years
Patients who underwent laparoscopic surgery by a gynecologist
Surgical indications: May benefit from concomitant appendectomy (e.g., endometriosis or chronic pelvic pain)
Data from The American College of Surgeons National Surgical Quality Improvement Program database
Matched cohort was created by computing propensity scores
All patients undergoing appendectomy were 1:1 matched to a unique patient who did not undergo appendectomy based on demographic and surgical characteristics
Postoperative outcomes in the 30 days following surgery
Underwent concomitant appendectomy: 0.7%
Complications rate was higher in the appendectomy group (P<0.001)
Without appendectomy: 5.5%
Propensity-matched sample results were similar
Patients who underwent appendectomy had significantly higher rates of readmission
Without appendectomy: 2.3%
This remained significant in the propensity-matched sample
There were no differences in
Rates of postoperative thromboembolic events | blood transfusion | reoperation
Appendectomy at the time of laparoscopic gynecologic surgery is associated with higher rates of complications and readmissions
The authors state
Despite a statistically significant increase in composite postoperative outcomes, the rates of each individual complication in the appendectomy group were low, ranging from 0.1% to 2.8%. Rates of major complications, including venous thromboembolism, blood transfusion and reoperation, were similar between the groups
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