Badiner Nora, Mirzadeh Angela, Sword Lauren, Herberger Mary, Butler Hayley, Yao Ruofan, Ioffe Yevgeniya, Hong Linda
Loma Linda University Medical Center, Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, 11175 Campus Street, Coleman Pavilion, Room #11105, Loma Linda, CA 92354, United States.
Loma Linda University Medical Center, Department of Gynecology and Obstetrics, 11175 Campus Street, Coleman Pavilion, Room #11105, Loma Linda, CA 92354, United States.
Gynecol Oncol Rep. 2025 Aug 18;61:101926. doi: 10.1016/j.gore.2025.101926. eCollection 2025 Oct.
The role of appendectomy in gynecologic oncology surgery has primarily been studied in mucinous ovarian pathologies. We sought to assess the safety and potential benefits of performing incidental appendectomy at time of exploratory laparotomy performed by gynecologic oncologists.
Retrospective chart review of patients undergoing exploratory laparotomy with the gynecologic oncology division. Exclusion criteria included cesarean hysterectomy and reoperation. Patients were matched on BMI, procedure date and type. 513 patients were identified for inclusion: 169 patients underwent appendectomy and 344 patients did not. Demographic and clinical characteristics were abstracted from the electronic medical record. Appendiceal appearance was confirmed via pathology report. Safety outcomes included length of hospital stay and postoperative complications.
The two groups were demographically similar. There was no significant difference in length of hospital stay between the cohorts (6.10 ± 5.34 days vs. 5.87 ± 5.34 days, P = 0.645) and no increased rate of any of the postoperative complications in the appendectomy group. 119 patients (70.4 %) had abnormal appendixes intraoperatively. Among normal appendixes, six (12 %) had an occult finding only diagnosed on final pathology. No patients with apparent pelvic-confined gynecologic cancer were upstaged solely due to metastasis to the appendix.
When performed by a gynecologic oncologist, appendectomy at the time of laparotomy was safe and did not increase the risk of complications. Our results demonstrate a high rate of occult abnormal histology despite a normal intraoperative appearance. These findings suggest that intraoperative appearance alone is not sufficient, and support performing incidental appendectomy at the time of gynecologic oncology exploratory laparotomy.
阑尾切除术在妇科肿瘤手术中的作用主要在黏液性卵巢病变中进行了研究。我们试图评估妇科肿瘤学家在进行剖腹探查术时同时进行阑尾切除术的安全性和潜在益处。
对妇科肿瘤科室接受剖腹探查术的患者进行回顾性病历审查。排除标准包括剖宫产子宫切除术和再次手术。根据体重指数、手术日期和类型对患者进行匹配。确定513例患者纳入研究：169例患者接受了阑尾切除术，344例患者未接受。从电子病历中提取人口统计学和临床特征。通过病理报告确认阑尾外观。安全结果包括住院时间和术后并发症。
两组在人口统计学上相似。两组之间的住院时间无显著差异（6.10±5.34天对5.87±5.34天，P = 0.645），阑尾切除术组的任何术后并发症发生率均未增加。119例患者（70.4%）术中阑尾异常。在正常阑尾中，6例（12%）有仅在最终病理检查时才被诊断出的隐匿性发现。没有明显盆腔局限性妇科癌症患者仅因阑尾转移而分期升高。
由妇科肿瘤学家进行时，剖腹手术时的阑尾切除术是安全的，不会增加并发症风险。我们的结果表明，尽管术中外观正常，但隐匿性异常组织学的发生率很高。这些发现表明仅靠术中外观是不够的，并支持在妇科肿瘤剖腹探查术时进行阑尾切除术。
