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The utility of laparoscopy in the diagnosis of acute appendicitis in women of reproductive age . AIM To see whether laparoscopy improves the accuracy of a clinical diagnosis of acute appendicitis in women of reproductive age , and to determine what the long-term sequelae are of not removing an appendix deemed at laparoscopy to be normal . METHOD The initial part of the study was undertaken during 1991-1992 . Female patients between 16 and 45 years were eligible for inclusion once a clinical decision had been made to perform an appendicectomy for suspected acute appendicitis . Following consent , patients were randomized into two groups . One group had open appendicectomy , as planned . The other group had laparoscopy , followed by open appendicectomy only if the appendix was seen to be inflamed or was not visualized . The end points for the study were the clinical outcomes of all patients , and the results of histology , where appropriate . An attempt was made to contact all patients at 10 years to determine whether they had had a subsequent appendicectomy , or had been diagnosed with another abdominal condition that might be relevant to the initial presentation in 1991-1992 . RESULTS Laparoscopic assessment was correct in all cases in which the appendix was visualized . Diagnostic accuracy was improved from 75 % to 97 % . Laparoscopy was associated with no added complications , no increase in hospital stay in patients who went on to appendicectomy , and a reduction in hospital stay for those who underwent laparoscopy alone . No patients developed a problem over the 10-year follow-up period from having a normal-looking appendix not removed at laparoscopy . CONCLUSION Laparoscopic assessment of the appendix is reliable , and to leave a normal-looking appendix at laparoscopy does not appear to cause any long-term problems .
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Intervention_Physical
laparoscopy
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Intervention_Surgical
open appendicectomy
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Intervention_Physical
laparoscopy
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Intervention_Surgical
open appendicectomy
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Outcome_Other
histology
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Outcome_Other
Diagnostic accuracy
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Outcome_Adverse-effects
no added complications
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Outcome_Other
no increase in hospital stay
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Outcome_Other
reduction in hospital stay