Our Summary

This research paper is about a study conducted to test the effectiveness of the Laparoscopic APPendicitis (LAPP) score in deciding whether or not to remove a patient’s appendix during surgery. The study involved 322 adult patients who were suspected of having appendicitis and were scheduled for diagnostic surgery. Depending on their LAPP score, doctors either removed their appendix or left it as is. These patients were then compared to a group of 584 patients who were treated without using the LAPP score.

The results showed that using the LAPP score significantly reduced the instances of removing a healthy appendix. None of the patients who had their appendix left in place, based on a negative LAPP score, developed appendicitis within three months. The use of the LAPP score did not significantly affect the operation time, complications, or readmissions but was associated with more pre-surgery imaging.

In other words, the LAPP score was found to be a safe and simple tool that helps doctors make better decisions during surgery and decreases the chances of removing a healthy appendix without missing cases of actual appendicitis.

FAQs

  1. What is the LAPP score and how is it used in relation to appendectomy surgeries?
  2. Did using the LAPP score have any impact on other surgery-related factors like operation time, complications, or readmissions?
  3. What were the key outcomes of the research study on the effectiveness of the LAPP score in deciding whether or not to remove a patient’s appendix during surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about appendectomy is to trust in the decision-making process during surgery. The use of tools like the LAPP score can help ensure that only necessary appendectomies are performed, reducing the risk of complications and unnecessary surgery. It’s important for patients to communicate openly with their healthcare team and ask any questions they may have about the procedure. Trusting in the expertise of the medical professionals involved can help ensure a successful outcome.

Suitable For

Patients who are suspected of having appendicitis are typically recommended for an appendectomy. This includes patients who present with classic symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever. Additionally, patients who have a history of recurrent appendicitis or have complications such as abscess formation or perforation may also be recommended for an appendectomy.

In the study mentioned above, the LAPP score was used to help determine which patients should undergo an appendectomy. The LAPP score takes into account various factors such as age, gender, temperature, white blood cell count, and imaging findings to determine the likelihood of appendicitis. Patients with a high LAPP score are more likely to have appendicitis and may be recommended for surgery.

Overall, patients who are experiencing symptoms of appendicitis or have a high likelihood of having appendicitis based on clinical and laboratory findings are typically recommended for an appendectomy. The use of tools such as the LAPP score can help guide healthcare providers in making more informed decisions about which patients should undergo surgery.

Timeline

Before the appendectomy:

  1. Patient experiences symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever.
  2. Patient undergoes physical examination and possibly blood tests and imaging studies to confirm the diagnosis of appendicitis.
  3. Doctors may use the LAPP score to determine whether the patient’s appendix should be removed or not.
  4. If the LAPP score indicates a high likelihood of appendicitis, the patient is scheduled for surgery.

After the appendectomy:

  1. Patient undergoes laparoscopic surgery to remove the inflamed appendix.
  2. Patient is monitored closely post-surgery for any complications.
  3. Patient may experience pain and discomfort at the incision site.
  4. Patient is instructed on post-operative care, including pain management and wound care.
  5. Patient is discharged from the hospital once they have recovered sufficiently.
  6. Patient follows up with their doctor for a check-up to ensure proper healing and no complications.

What to Ask Your Doctor

  1. How does the LAPP score work and how is it calculated?
  2. What are the benefits of using the LAPP score in deciding whether or not to remove the appendix during surgery?
  3. What are the potential risks or limitations of using the LAPP score?
  4. How does the use of the LAPP score affect the overall surgical outcome and recovery process?
  5. Are there any specific criteria or guidelines for when the LAPP score should be used in evaluating appendicitis?
  6. How does the LAPP score compare to other methods or tools used in diagnosing and treating appendicitis?
  7. What follow-up care or monitoring may be needed after using the LAPP score during surgery?
  8. How long has the LAPP score been used in clinical practice and what is the research or evidence supporting its effectiveness?
  9. Are there any specific considerations or factors that may affect the accuracy or reliability of the LAPP score in certain patients or situations?
  10. Can you provide more information or resources for me to learn more about the LAPP score and its use in appendectomy procedures?

Reference

Authors: Gelpke K, Hamminga JTH, van Bastelaar JJ, de Vos B, Bodegom ME, Heineman E, Hofker HS, El Moumni M, Haveman JW. Journal: Int J Surg. 2020 Jul;79:257-264. doi: 10.1016/j.ijsu.2020.04.041. Epub 2020 May 6. PMID: 32387211