Engin Omer, Calik Bulent, Yildirim Mehmet, Coskun Ali, Coskun Gulnihal Ay
Department of Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
J Korean Surg Soc. 2011 Apr;80(4):267-71. doi: 10.4174/jkss.2011.80.4.267. Epub 2011 Apr 12.
Appendectomy applied from the diagnosis of acute appendicitis is one the most common operations in surgery. The rates of negative appendectomy are still high. The rates of negative appendectomy in males and females differ and are higher in females. In our study, these differences, particularly in females, were studied and possible solutions were discussed.
Between October 2002 and October 2009, among women receiving urgent appendectomies, those whose primary cause was gynecological pathology were studied retrospectively. All our women subjects were examined by preoperative gynecologists. After gynecological consultation, the patients were evaluated by a general surgeon due to lack of urgent ultrasonography, computed tomography (CT) and diagnostic laparoscopy and the patient received appendectomy due to acute appendicitis.
In our series of 1,969 appendectomies, the rate of female/male is 811/1,158. It was determined that the primary cause in 47 (47/811; 5.8%) women with applied appendectomy was gynecological pathology. As a gynecological pathology, it was observed that the most common cause was ovarian cyst ruptures at a rate of 72.3%. The negative appendectomy rate in males was found to be 14.94% (173/1,158), and in females it was 22.56% (183/811). The difference between them is significant (P < 0.01). Of these women, 5.8% were gynecologically-induced and 16.76% were unrelated to gynecological causes.
We believe that gynecological consultation before appendectomy in women is necessary, but not sufficient. It is also important that at least one of the facilities, such as us, CT, magnetic resonance imaging, and diagnostic laparoscopy should be available in surgical use for the diagnosis of negative appendicitis.
自急性阑尾炎诊断起施行的阑尾切除术是外科最常见的手术之一。阴性阑尾切除术的比例仍然很高。男性和女性的阴性阑尾切除术比例有所不同，女性更高。在我们的研究中，对这些差异，尤其是女性中的差异进行了研究，并讨论了可能的解决办法。
在2002年10月至2009年10月期间，对接受急诊阑尾切除术的女性中以妇科病理为主要病因的患者进行回顾性研究。所有女性受试者均由术前妇科医生进行检查。经过妇科会诊后，由于缺乏急诊超声、计算机断层扫描（CT）和诊断性腹腔镜检查，患者由普通外科医生进行评估，并因急性阑尾炎接受阑尾切除术。
在我们的1969例阑尾切除术系列中，女性/男性比例为811/1158。确定在接受阑尾切除术的47例（47/811；5.8%）女性中，主要病因是妇科病理。作为妇科病理，观察到最常见的病因是卵巢囊肿破裂，比例为72.3%。男性的阴性阑尾切除术比例为14.94%（173/1158），女性为22.56%（183/811）。两者之间的差异具有统计学意义（P<0.01）。在这些女性中，5.8%是由妇科疾病引起的，16.76%与妇科病因无关。
我们认为，女性在阑尾切除术前行妇科会诊是必要的，但并不充分。对于阴性阑尾炎的诊断，外科手术中至少应具备诸如超声、CT、磁共振成像和诊断性腹腔镜检查等设备中的一种，这也很重要。
