LAPAROSCOPIC APPENDECTOMY - IS IT WORTHWHILE - A PROSPECTIVE, RANDOMIZED STUDY IN YOUNG-WOMEN

Background: Clinical diagnosis of acute appendicitis is most difficult in fertile-age women. In this patient group up to 50% of open appende ctomies are negative for appendicitis. We conducted a randomized study to compare laparoscopic and open appendectomy in young female patient s with suspected acute appendicitis. Methods: Fifty female patients be tween the ages of 16 and 40 years presenting with acute right lower ab dominal pain were randomized, 25 to laparoscopy and 25 to an open appe ndectomy. Diagnostic accuracy, rate of negative appendectomies, safety , and final outcome were compared in the two groups. Results: Diagnosi s was established in 96% of patients in the laparoscopic group and in 72% in the open group. There were 11 (44%) unnecessary appendectomies in the open group, but only one (4%) in the laparoscopic group (p < 0. 0005). Conclusions: In young women with right lower abdominal pain, la paroscopy can give precise diagnosis and reduce the rate of negative a ppendectomies.