Leibovitch I, Rowland R G, Goldwasser B, Donohue J P
Department of Urology, Indiana University School of Medicine, Indianapolis, USA.
J Urol. 1995 Sep;154(3):1110-2.
To investigate the issue of incidental appendectomy during urological surgery we retrospectively studied its consequences in 2 groups of urological patients.
We studied 147 patients undergoing cystectomy and urinary diversion (group 1) and 200 undergoing primary retroperitoneal lymphadenectomy (group 2). Incidental appendectomy was performed in 122 (83%) and 114 (57%) patients, respectively.
The incidence of infectious complications in group 2 was significantly higher among patients who underwent incidental appendectomy compared to those without appendectomy (9.6% and 2.3%, respectively, p = 0.032). No difference was noted among the patients in group 1 (10.6% and 12.0%, respectively, p = 0.51).
When evaluating the prophylactic merits, incidental appendectomy can be performed safely during radical cystectomy and urinary diversion. It is probably contraindicated in patients undergoing retroperitoneal lymphadenectomy for testis cancer due to the apparent added risk of infectious complications.
为了研究泌尿外科手术中附带阑尾切除术的问题，我们回顾性地研究了两组泌尿外科患者的相关后果。
我们研究了147例行膀胱切除术及尿流改道术的患者（第1组）和200例行原发性腹膜后淋巴结清扫术的患者（第2组）。分别有122例（83%）和114例（57%）患者接受了附带阑尾切除术。
在第2组中，接受附带阑尾切除术的患者感染并发症发生率显著高于未接受阑尾切除术的患者（分别为9.6%和2.3%，p = 0.032）。第1组患者之间未发现差异（分别为10.6%和12.0%，p = 0.51）。
在评估预防性优点时，在根治性膀胱切除术及尿流改道术期间可安全地进行附带阑尾切除术。对于因睾丸癌而行腹膜后淋巴结清扫术的患者，由于明显增加了感染并发症的风险，附带阑尾切除术可能是禁忌的。
