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Historically, the procedure included performing an appendectomy to prevent future misdiagnosis of appendicitis, since the location of the appendix will be shifted to the left side of the abdomen. This study consists of two parts. A review of the available literature on appendectomy as part of Ladd\u2019s procedure and then a survey sent to pediatric surgeons about their approach (to remove the appendix or not) while performing a Ladd\u2019s procedure and the clinical reasoning behind their approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study consists of 2 parts: (1) a systematic review was performed to extract articles that fulfill the inclusion criteria; (2) a short online survey was designed and sent by email to 168 pediatric surgeons. The questions in the survey were centered on whether a surgeon performs an appendectomy as part of the Ladd\u2019s procedure or not, as well as their reasoning behind either choice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The literature search yielded five articles, the data from the available literature are inconsistent with performing appendectomy as part of Ladd's procedure. The challenge of leaving the appendix in place has been briefly described with minimal to no focus on the clinical reasoning. The survey demonstrated that 102 responses were received (60% response rate). Ninety pediatric surgeons stated performing an appendectomy as part of the procedure (88%). Only 12% of pediatric surgeons are not performing appendectomy during Ladd\u2019s procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>It is difficult to implement a modification in a successful procedure like Ladd\u2019s procedure. The majority of pediatric surgeons perform an appendectomy as part of its original description. This study has identified gaps in the literature pertaining to analyze the outcomes of performing Ladd's procedure without an appendectomy which should be explored in future research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00383-023-05437-7","type":"journal-article","created":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T08:28:46Z","timestamp":1680510526000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Appendectomy as part of Ladd\u2019s procedure: a systematic review and survey analysis"],"prefix":"10.1007","volume":"39","author":[{"given":"Montaser Nabeeh","family":"Al Smady","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salama Bin","family":"Hendi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"AlJeboury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hessa","family":"Al Mazrooei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussein","family":"Naji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,4,3]]},"reference":[{"issue":"6","key":"5437_CR1","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1016\/j.amjsurg.2007.08.035","volume":"194","author":"MR McVay","year":"2007","unstructured":"McVay MR, Kokoska ER, Jackson RJ, Jack SSD, Award B (2007) The changing spectrum of intestinal malrotation: diagnosis and management. 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