Our Summary

This research paper studies the effectiveness of a tool called the Laparoscopic APPendicitis (LAPP) score in reducing unnecessary appendectomies (surgical removal of the appendix). The study found that sometimes, about 9% of the time, surgeries are performed to remove a healthy appendix. This can lead to more health problems and even death, compared to surgeries that remove an inflamed appendix.

The LAPP score was created to help doctors determine if the appendix is really inflamed and needs to be removed. The study involved 322 adults who were suspected of having an inflamed appendix. The LAPP score was used to decide if their appendix should be removed or not.

The results of the study showed that the LAPP score was successful in reducing the number of unnecessary surgeries. The rate of unnecessary surgeries dropped from 8.4% to 4.7%. None of the patients who kept their appendix due to a negative LAPP score developed an inflamed appendix within three months.

The study also found no significant changes in the length of the operation, complications, or readmissions. However, the use of the LAPP score did result in a higher use of pre-operation imaging, like X-rays or ultrasounds.

In conclusion, the study found that the LAPP score is a safe and simple tool that can help reduce the number of unnecessary appendectomies without missing any cases of actual inflamed appendix.

FAQs

  1. What is the Laparoscopic APPendicitis (LAPP) score and what is it used for?
  2. What was the impact of using the LAPP score on the rate of unnecessary appendectomies?
  3. Did the use of the LAPP score result in any changes in operation length, complications, or readmission rates?

Doctor’s Tip

A helpful tip a doctor might give a patient about laparoscopic appendectomy is to ask about the use of the LAPP score to determine if their appendix truly needs to be removed. This tool can help ensure that the surgery is necessary and reduce the risk of complications from removing a healthy appendix. It’s important for patients to advocate for their own health and ask questions about their treatment options.

Suitable For

Patients who are suspected of having an inflamed appendix but do not have severe symptoms or clear indications of appendicitis are typically recommended for a laparoscopic appendectomy. The use of the LAPP score in these cases can help doctors make a more informed decision about whether surgery is necessary, reducing the risk of unnecessary surgeries and potential complications for patients.

Timeline

Before laparoscopic appendectomy:

  • Patient experiences symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever
  • Patient undergoes physical examination and diagnostic tests such as blood tests, urine tests, and imaging studies (CT scan or ultrasound) to confirm the diagnosis
  • If appendicitis is confirmed, patient is scheduled for laparoscopic appendectomy surgery

After laparoscopic appendectomy:

  • Patient undergoes laparoscopic appendectomy surgery, which is a minimally invasive procedure where small incisions are made in the abdomen to remove the inflamed appendix
  • Recovery time is shorter compared to open appendectomy surgery, with most patients able to go home the same day or the next day
  • Patient may experience some pain, discomfort, and bloating after surgery, which can be managed with pain medication
  • Patient is advised to rest, avoid strenuous activities, and follow a specific diet to aid in recovery
  • Follow-up appointments with the surgeon may be scheduled to monitor healing and ensure there are no complications

Overall, laparoscopic appendectomy is a safe and effective treatment for appendicitis, with the use of tools like the LAPP score helping to reduce unnecessary surgeries and improve patient outcomes.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic appendectomy include:

  1. What is the LAPP score and will it be used to determine if my appendix needs to be removed?
  2. What are the risks and benefits of undergoing a laparoscopic appendectomy?
  3. How will the surgery be performed and what is the recovery process like?
  4. Are there any alternative treatments or options available for my condition?
  5. What are the potential complications of the surgery and how likely are they to occur?
  6. How long will I need to stay in the hospital after the surgery?
  7. How soon can I expect to return to normal activities and work after the surgery?
  8. Will I need any follow-up appointments after the surgery?
  9. What can I do to prepare for the surgery and improve my recovery?
  10. Are there any specific dietary or lifestyle changes I should make after the surgery to prevent future issues with my appendix?

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