Primary appendectomy.

A review of 403 patients undergoing appendectomy in a community hospital led to the following conclusions. Appendectomy with the finding of a normal appendix and no other condition requiring operation was accompanied by a higher complication rate and longer hospitalization than appendectomy for nonperforated diseased appendix. A high frequency of removal of normal appendices did not result in a lower incidence of appendiceal perforation. An increased diagnostic accuracy in the surgical treatment of "acute appendicitis" was not associated with increased incidence of appendiceal perforation. These findings support the thesis that a more discriminate diagnosis of acute appendicitis will lower the incidence of unnecessary appendectomy without increasing the morbidity from unrecognized appendiceal disease.