Laparoscopy reduces unnecessary appendicectomies and improves diagnosis infertile women - A randomized study

Background: The aim of this study was to study the value of diagnostic lapa roscopy prospectively in fertile women scheduled for acute appendectomy. Methods: For this study, 110 women, with acute abdominal pain ages 15 to 47 years, in whom the surgeon had decided to perform an appendectomy, were ra ndomized to either open appendectomy or diagnostic laparoscopy, then open a ppendectomy if necessary. Results: Appendicitis was diagnosed in 66% of the women after open surgery, and in 73% after laparoscopy. During laparoscopy, was appendicitis misdiag nosed in only 7% of the women, from whom the appendix unnecessarily removed , whereas 34% in the open surgery group had a healthy appendix removed. No appendicitis was missed in the laparoscopic group. The relative risk of rem oving a healthy appendix in open surgery was 6.6 relative risk (range, 2-21 C.I.) as compared with laparoscopy. Among the women with a healthy appendi x, a gynecologic diagnosis was found in 73% after laparoscopy, as compared with 17% after open surgery. Conclusions: Laparoscopy reduces unnecessary appendectomies and improves di agnosis in fertile women.