{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:18:45Z","timestamp":1786979925391,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Right iliac fossa (RIF) pain is a common indication for laparoscopy to diagnose and treat appendicitis. When a macroscopically normal appendix is found, there is no standard consensus regarding excision. Some surgeons remove the appendix due to the risk of microscopic inflammation and to avoid a future, repeat laparoscopy for possible appendicitis. Alternatively, others leave the appendix in situ to avoid morbidity from a potentially unnecessary procedure. We aimed to evaluate the outcomes of patients with macroscopically normal appendices left in situ.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All emergency laparoscopies without appendicectomy between January 1st 2010\u2010 December 31st 2020 were identified from theatre records. All operative notes were individually evaluated and comments on the macroscopic appearance of the appendix and any intra\u2010operative pathology were recorded. Only patients undergoing laparoscopy for suspected appendicitis with macroscopically normal appendices were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 120 patients [median age 21.68 (range 9\u201390.8) years] were included. The cohort was predominantly female (\n                      <jats:italic>n<\/jats:italic>\n                      =105, 87.5%). Forty\u2010eight patients (40.0%) had a positive finding during index laparoscopy. During a median duration of 94.5 (range 8\u2013131) months\u2019 follow\u2010up, 16 patients (13.33%) underwent a repeat laparoscopy for recurrent RIF pain. Thirteen (10.8% of total cohort) subsequently underwent an appendicectomy. Histology confirmed acute appendicitis in six cases (4.17% of entire cohort). On subanalysis of smaller cohort, index laparoscopies with no positive findings (\n                      <jats:italic>n<\/jats:italic>\n                      =72), nine patients (12.5%) underwent appendicectomy with two (2.7%) appendices demonstrating appendicitis on histological examination.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>87% of the total cohort with a normal appendix at laparoscopy for RIF pain did not undergo further laparoscopy. Less than 5% of the total cohort and 2.7% of subanalysis cohort had an appendicectomy for histologically\u2010proven appendicitis within the follow\u2010up period. From the evidence in this study, we conclude that leaving the appendix in situ unless macroscopically inflamed is a viable alternative to excision.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-022-06497-x","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T14:02:37Z","timestamp":1646920957000},"page":"1353-1358","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Outcomes of the Macroscopically Normal Appendix Left in Situ in Patients with Suspected Appendicitis"],"prefix":"10.1002","volume":"46","author":[{"given":"Sara","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Academic Surgery University Hospital Waterford, University College Cork Dunmore Road Waterford Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara M.","family":"Connelly","sequence":"additional","affiliation":[{"name":"Department of Academic Surgery University Hospital Waterford, University College Cork Dunmore Road Waterford Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica M.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Academic Surgery University Hospital Waterford, University College Cork Dunmore Road Waterford Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Power\u2010Foley","sequence":"additional","affiliation":[{"name":"Department of Academic Surgery University Hospital Waterford, University College Cork Dunmore Road Waterford Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Neary","sequence":"additional","affiliation":[{"name":"Department of Academic Surgery University Hospital Waterford, University College Cork Dunmore Road Waterford Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017\u2010017\u20100122\u20109"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001378"},{"key":"e_1_2_7_4_1","volume-title":"Appendicitis","author":"Jones MW","year":"2021"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588412X13373405385377"},{"issue":"3","key":"e_1_2_7_6_1","first-page":"123","article-title":"Short\u2010term outcome of open appendectomy in Southern Iran: a single center experience","volume":"1","author":"Paydar S","year":"2013","journal-title":"Bull Emerg 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appendicitis","volume":"1","author":"Chan JFK","year":"2020","journal-title":"Ulster Med J"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010018\u20104784\u20106"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201058847\u20101"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/110241500750008943"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.185.2.01850406"},{"issue":"7","key":"e_1_2_7_22_1","first-page":"216","article-title":"Assessment of the value of pelvic ultrasonography in pre\u2010menopausal women with right iliac fossa pain","volume":"101","author":"Stunell H","year":"2008","journal-title":"Ir Med J Jul\u2010Aug"}],"container-title":["World Journal of 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