Gynecologic pathologies in our appendectomy series and literature review / 대한외과학회지

PURPOSE: Appendectomy applied from the diagnosis of acute appendicitis is one the most common operations in surgery. The rates of negative appendectomy are still high. The rates of negative appendectomy in males and females differ and are higher in females. In our study, these differences, particularly in females, were studied and possible solutions were discussed. METHODS: Between October 2002 and October 2009, among women receiving urgent appendectomies, those whose primary cause was gynecological pathology were studied retrospectively. All our women subjects were examined by preoperative gynecologists. After gynecological consultation, the patients were evaluated by a general surgeon due to lack of urgent ultrasonography, computed tomography (CT) and diagnostic laparoscopy and the patient received appendectomy due to acute appendicitis. RESULTS: In our series of 1,969 appendectomies, the rate of female/male is 811/1,158. It was determined that the primary cause in 47 (47/811; 5.8%) women with applied appendectomy was gynecological pathology. As a gynecological pathology, it was observed that the most common cause was ovarian cyst ruptures at a rate of 72.3%. The negative appendectomy rate in males was found to be 14.94% (173/1,158), and in females it was 22.56% (183/811). The difference between them is significant (P < 0.01). Of these women, 5.8% were gynecologically-induced and 16.76% were unrelated to gynecological causes. CONCLUSION: We believe that gynecological consultation before appendectomy in women is necessary, but not sufficient. It is also important that at least one of the facilities, such as us, CT, magnetic resonance imaging, and diagnostic laparoscopy should be available in surgical use for the diagnosis of negative appendicitis.

Is repair of incisional hernias by polypropylene mesh a safe procedure?

The aim of our study was to evaluate the safety of the intraperitoneal mesh repair procedure and to assess the complications that develop after the procedure. We reviewed the records of 25 patients who underwent intraperitoneal mesh repair procedures. Data on age, sex, size and cause of the hernia, postoperative mortality, and morbidity with special attention to complications were obtained from the medical records. Of the 25 patients [7 males, 18 females], the original operation was cholecystectomy in 15 cases [60%], gynaecological surgery in 2, gastric surgery in 2, and umbilical hernia in 2. Incisions were midline in 20 cases [80%], transverse in 2 and laparoscopic port sites in 3 patients. The average size of the hernia was 150 cm[2]. Local complications occurred in 4 [16%] patients. Postoperative complications included wound infection in 3 patients and haematoma in 1 patient. Postoperative hospital stay ranged from 3 to 25 days with a mean of 6 days. No recurrence developed during 28-month follow-up. The tension-free repair of incisional hernia with polypropylene mesh in intraperitoneal position is a safe and easy procedure with acceptable morbidity and no recurrence