tag:blogger.com,1999:blog-2760353953251845523.post6857846982153272410..comments2024-02-10T02:14:39.898-05:00Comments on Buckeye Surgeon: The Increasingly Unacceptable Negative AppendectomyJeffrey Parks MD FACShttp://www.blogger.com/profile/15650563299849196122noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-2760353953251845523.post-14053895151896650752013-10-06T04:30:30.665-04:002013-10-06T04:30:30.665-04:00I see nobody answered. I'll try myself:
For mo...I see nobody answered. I'll try myself:<br />For most doctors a Neg. App. is appendectomy of a not inflamed appendix. For me a NApp is an appendectomy that did not cure the patient. Both in hindsight.<br />A not inflamed appendix can give painful colics as well.<br />So with long standing pain in the RUQ and and doing laparoscopy : remove the thing. 80% Chance of success, evidence based in literature.Hendriknoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-12803091682298173572012-03-06T08:07:16.323-05:002012-03-06T08:07:16.323-05:00What is the definition of a Negative Appendectomy ...What is the definition of a Negative Appendectomy in an era of 'evidence based' surgery?Hendriknoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-40675063728574965922010-09-05T09:20:12.997-04:002010-09-05T09:20:12.997-04:00The counter argument is that a diagnostic laparosc...The counter argument is that a diagnostic laparoscopy is lower long-term risk than a CT scan in an otherwise healthy 16yo.<br /><br />I almost never scan anyone below the age of 40. Clearcut cases go to theatre; iffy cases get 12-24 hours to declare themselves / get better, and then they go to theatre.<br /><br />With a negative laparoscopy, do you take out the appendix anyhow?DHShttps://www.blogger.com/profile/00251680600047999918noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-62615176900624132352010-08-15T06:27:52.160-04:002010-08-15T06:27:52.160-04:00You should be happy with a 15-20% negative appende...You should be happy with a 15-20% negative appendectomy rate. Everywhere in the civilized world there are reported rates between 15-24% so going as down as 5%-1,7% sounds to me a little bit extreme. I'm not saying it's impossible, but that's the ideal and realizable in large academic hospitals where you'll do a CT, MRI, angiogram for the most obvious clinical proven pathology. But that's not the case for the under-financed hospitals (most of them), where ultrasonography remains the standard even today. Cheap, easy to do, most specialists are able to do it (they should be able to anyways). Here's where false positive diagnosis, position of the appendix count and CT makes the difference. Negative appendectomies are not so bad after all. Take the appendix out before being sorry.Sergiunoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-15276758650747182002010-08-13T18:11:47.617-04:002010-08-13T18:11:47.617-04:00I just heard about your blog. It's very good. ...I just heard about your blog. It's very good. Coincidentally, you wrote about the negative appy rate just before I did. The other intersting thing about that article from Cornell is that 95% of recent patients had pre-op CT scans. Tonight I'm waiting to do an appendectomy on a 17 y.o. boy with a classic H&P for appendicitis who has a CT (orderd by the ED MD)read as "Cannot entirely exclude early appendicitis."Skeptical Scalpelhttp://skepticalscalpel.blogspot.com/2010/08/appendicitis-diagnosis-ct-scans-and.htmlnoreply@blogger.com