Diagnostic laparoscopy reduces unnecessary appendicectomy in fertile women.

OBJECTIVE

To assess the value of laparoscopy in the accurate diagnosis of appendicitis in women of child-bearing age.

DESIGN

Prospective randomised trial.

SETTING

University hospital, Kuwait.

SUBJECTS

100 patients who fulfilled the inclusion criteria between July 1988 and March 1990.

INTERVENTIONS

50 patients were randomised to have diagnostic laparoscopy followed by appendicectomy if necessary, and the other 50 to have immediate appendicectomy.

MAIN OUTCOME MEASURES

Avoidance of unnecessary appendicectomy, length of operating time, and length of stay in hospital.

RESULTS

19 of 50 patients in the study group did not require appendicectomy (38%). One patient required an emergency operation for an ectopic pregnancy. Of the remaining 30, only 4 of the removed appendixes showed no histological abnormality (13%). There were no complications of laparoscopy.

CONCLUSION

Laparoscopy is a safe and effective way of diagnosing acute appendicitis and should be used more often.