Evaluation of liver transplant recipients underwent incidental appendectomies

OBJECTIVE: To assess the clinicopathological features of liver transplant recipients underwent incidental appendectomies. METHODS: Between September 2002 and July 2019, 2500 patients underwent liver transplantation at our Liver Transplant Institute, including 38 (24 males, 14 females) who also underwent incidental appendectomies. Incidental appendectomies were performed on 24 patients during recipient hepatectomies and on 14 during relaparotomies due to various surgical conditions. The following patient parameters were retrospectively evaluated: age, sex, underlying liver disease, liver transplant type, appendectomy indication, appendix length (mm) and diameter (mm), presence of appendicitis, and histopathological findings. RESULTS: The 38 patients who underwent incidental appendectomies had a mean age of 18.3±21.7 (range: 1–66) years and median appendix lengths and diameters of 55 (range: 19–90) mm and 6 (range: 4–20) mm, respectively. Histopathologically, the appendectomy specimens were classified as follows: vermiform appendix (n=16), lymphoid hyperplasia (n=13), acute appendicitis (n=3), fibrous obliteration (n=3), perforated appendicitis (n=1), mucinous cystadenoma (n=1), and appendiceal serosa invasion by sigmoid adenocarcinoma (n=1). There were no postoperative complications, including wound infections, abscesses, or leakage from the appendiceal stumps, related to the incidental appendectomies. CONCLUSION: This study demonstrated that incidental appendectomies can be successfully performed in immunosuppressed patients. However, additional studies are required to confirm these results.

[1]  E. Samdanci,et al.  Histopathological features of incidental appendectomy specimens obtained from living liver donors. , 2020, The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology.

[2]  C. Aydin,et al.  Determination of risk factors affecting mortality in patients with gastrointestinal perforation after pediatric liver transplantation , 2019, Pediatric transplantation.

[3]  M. Stringer Acute appendicitis , 2017, Journal of paediatrics and child health.

[4]  Y. Juliano,et al.  Risk factors associated with complications of acute appendicitis. , 2017, Revista do Colegio Brasileiro de Cirurgioes.

[5]  D. Ozgediz,et al.  Pediatric incidental appendectomy: a systematic review , 2016, Pediatric Surgery International.

[6]  S. Akbulut Accurate definition and management of idiopathic sclerosing encapsulating peritonitis. , 2015, World journal of gastroenterology.

[7]  N. Şahin,et al.  Unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. , 2013, World journal of gastroenterology.

[8]  Z. Arikanoglu,et al.  Unusual histopathological findings in appendectomy specimens: a retrospective analysis and literature review. , 2011, World journal of gastroenterology.

[9]  D. Chang,et al.  Negative appendectomy: a 10-year review of a nationally representative sample. , 2011, American journal of surgery.

[10]  H. Kelly UNDER WHAT CIRCUMSTANCES IS IT ADVISABLE TO REMOVE THE VERMIFORM APPENDIX WHEN THE ABDOMEN IS OPENED FOR OTHER REASONS , 1902 .

[11]  B. D. S. Rodrigues,et al.  Incidental and Prophylactic Appendectomy in Clinical Practice: A Review Article , 2018 .

[12]  Chung‐Han Ho,et al.  The Value of Incidental Appendectomy in Lower Abdominal Surgery : A Retrospective Study of Taiwan ’ s National Health Insurance Research Database , 2017 .