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This study seeks to justify performing an incidental appendectomy according to the following hypotheses:
A retrospective cross-sectional study will be done. The archive of all PHD findings will be searched, and then the relevant medical histories at the Clinic of Surgery, University Hospital Center Split in the period from 01.01.2017. to 31.12.2021. The data collection will be done in the period from 01.02.2022. to 31.03.2022. The data collection (extraction) will be done by the main researcher (graduate, Ante Tavra) with at least two other colleagues from the Department of Abdominal-Coloproctological Surgery, University Hospital Center Split (Damir Quien, MD and Dora Bjelanović, MD).
Data will be collected directly from medical history and entered into an overview table. The identity of the respondents will remain secret, and the respondents will be marked exclusively with an identification number. This type of research does not require the informed consent of the patient, and all data collected will be kept in accordance with the provisions of Annex 2 of the Application to Institutional advisory board of UHC Split (approval pending).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Incidental appendectomy (IA) | Group IA will include adult patients operated on for colon tumors who have data on age, sex, data on a previously diagnosed colon tumor, data on incidental appendectomy, and a PHD finding for a removed vermiform appendix. |
| |
| Acute appendectomy (AA) | Group AA will include adult patients who have been operated due to clinical suspicion of acute appendicitis and have data on age, sex, data on the diagnosis of acute appendicitis and accompanying PHD findings of the performed appendectomy. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Appendectomy | Procedure | Surgical removal of the vermiform appendix. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of appendiceal neoplasms | Incidence of appendiceal neoplasms in IA which will be compared to the incidence of appendiceal neoplasms AA from respective PH samples. | 01.01.2017. - 31.12.2021. |
| NNT of IA for the appendiceal neoplasm | The number of needed incidental appendectomies necessary to avoid one occurence of appendiceal neoplasm | 01.01.2017. - 31.12.2021. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of complicated appendicits | Comparison of incidences of complicated appendicits in young vs elderly | 01.01.2017. - 31.12.2021. |
| NNT of IA for the complicated appendicits in elderly | The number of needed incidental appendectomies necessary to avoid one occurence of complicated appendicitis in elderly |
| Measure | Description | Time Frame |
|---|---|---|
| Size of the appendix as a predictor of neoplasm | Receiver operating curve analysis of the size of the vermiform appendix impacting the classification to neoplastic appendix | 01.01.2017. - 31.12.2021. |
| Definition of the elderly group for appendiceal neoplasm |
Inclusion Criteria:
Adult patients operated for colon tumors who have data on age, sex, data on a previously diagnosed colon tumor, data on incidental appendectomy, and a PHD finding for a removed appendix. Adult patients who have been diagnosed with acute appendicitis and have data on age, sex, data on the diagnosis of acute appendicitis and accompanying PHD findings, newly performed appendectomies.
Exclusion Criteria:
We will exclude from the analysis patients who had previous appendectomy, appendectomy has not been performed or we do not have an accompanying PHD finding of the appendix, and patients younger than 18 years.
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All the patients operated in UHC Split Surgery Clinic for colon cancer or acute appendicitis during 5-year period.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ognjen Barcot, MD, PhD | Contact | +385914344037 | ognjen.barcot@gmail.com | |
| Damir Quien, MD | Contact | +38521556420 | kolo@kbsplit.hr |
| Name | Affiliation | Role |
|---|---|---|
| Ognjen Barcot, MD, PhD | Department of surgery, University Hospital Split | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Split | Split | Split-Dalmatia County | 21000 | Croatia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32343238 | Result | Akbulut S, Koc C, Sarici B, Ozcan M, Samdanci E, Yilmaz S. Histopathological features of incidental appendectomy specimens obtained from living liver donors. Turk J Gastroenterol. 2020 Mar;31(3):257-263. doi: 10.5152/tjg.2020.19010. | |
| 28892212 | Result | Choksuwattanasakul M. Incidental appendectomy during mini incision post-partum sterilization (Chokchai technique): A prospective cross-sectional study. J Obstet Gynaecol Res. 2017 Dec;43(12):1863-1869. doi: 10.1111/jog.13458. Epub 2017 Sep 11. |
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The data will be available upon reasonable request by the corresponding author (Ognjen Barcot).
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| ID | Term |
|---|---|
| D001063 | Appendiceal Neoplasms |
| ID | Term |
|---|---|
| D002430 | Cecal Neoplasms |
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
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| ID | Term |
|---|---|
| D001062 | Appendectomy |
| ID | Term |
|---|---|
| D013505 | Digestive System Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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| 01.01.2017. - 31.12.2021. |
| NNT of IA for the death due to appendicits in elderly | The number of needed incidental appendectomies necessary to avoid one death from complicated appendicitis in elderly | 01.01.2017. - 31.12.2021. |
Receiver operating curve analysis of the age of the patient impacting the classification to neoplastic appendix
| 01.01.2017. - 31.12.2021. |
| Definition of the elderly group for the complicated appendicitis or death | Receiver operating curve analysis of the age of the patient impacting the classification to the complicated appendicitis or death | 01.01.2017. - 31.12.2021. |
| 19490638 | Result | Lohsiriwat V, Vongjirad A, Lohsiriwat D. Incidence of synchronous appendiceal neoplasm in patients with colorectal cancer and its clinical significance. World J Surg Oncol. 2009 Jun 2;7:51. doi: 10.1186/1477-7819-7-51. |
| 29098385 | Result | Huttenbrink C, Hatiboglu G, Simpfendorfer T, Radtke JP, Becker R, Teber D, Hadaschik B, Pahernik S, Hohenfellner M. Incidental appendectomy during robotic laparoscopic prostatectomy-safe and worth to perform? Langenbecks Arch Surg. 2018 Mar;403(2):265-269. doi: 10.1007/s00423-017-1630-5. Epub 2017 Nov 2. |
| 30705736 | Result | Akbulut S, Koc C, Kocaaslan H, Gonultas F, Samdanci E, Yologlu S, Yilmaz S. Comparison of clinical and histopathological features of patients who underwent incidental or emergency appendectomy. World J Gastrointest Surg. 2019 Jan 27;11(1):19-26. doi: 10.4240/wjgs.v11.i1.19. |
| 12115365 | Result | McCusker ME, Cote TR, Clegg LX, Sobin LH. Primary malignant neoplasms of the appendix: a population-based study from the surveillance, epidemiology and end-results program, 1973-1998. Cancer. 2002 Jun 15;94(12):3307-12. doi: 10.1002/cncr.10589. |
| 25681217 | Result | Segev L, Keidar A, Schrier I, Rayman S, Wasserberg N, Sadot E. Acute appendicitis in the elderly in the twenty-first century. J Gastrointest Surg. 2015 Apr;19(4):730-5. doi: 10.1007/s11605-014-2716-9. Epub 2015 Feb 14. |
| 32029830 | Result | Ahmed HO, Muhedin R, Boujan A, Aziz AHS, Abdulla AM, Hardi RA, Abdulla AA, Sidiq TA. A five-year longitudinal observational study in morbidity and mortality of negative appendectomy in Sulaimani teaching Hospital/Kurdistan Region/Iraq. Sci Rep. 2020 Feb 6;10(1):2028. doi: 10.1038/s41598-020-58847-1. |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D002429 | Cecal Diseases |
| D007410 | Intestinal Diseases |