Incidental appendectomy during robotic laparoscopic prostatectomy—safe and worth to perform?
The purpose of this study is to investigate the safety and patients’ benefit of incidental appendectomy during robot-assisted laparoscopic radical prostatectomy (RALRP).
Fifty-three patients, who had incidental appendectomy during RALRP between January 2012 and March 2014, were enrolled to this study. To evaluate the safety of the procedure, following parameters were evaluated: patient age, duration of surgery, perioperative complications (classified by Clavien-Dindo), time to bowel movement, and length of hospital stay. Furthermore, intraoperative visual appearance, location, and histopathological evaluation of the appendix were evaluated. Data was analyzed by descriptive statistics.
Mean age of patients was 61 years, the average hospital stay 5 days. No perioperative complications occurred. The appendix was unsuspicious in 39 patients (73.6%); 14 patients (26.4%) had macroscopically signs of inflammation.
Of the 53 resected appendixes, the histopathological evaluation showed 33 (62.2%) inconspicuous appendices, 11 (20.8%) post-inflammatory changes, 4 (7.5%) with chronical signs of inflammation and 3 (5.7%) with signs of acute inflammation. In 2 patients (3.8%), low-grade mucinous neoplasms were found in the specimens.
Incidental appendectomy during RALRP is a feasible procedure. With regard to inflammation and neoplastic changes, incidental appendectomy can be considered for patients scheduled for robot-assisted prostate surgery.
KeywordsIncidental appendectomy Laparoscopy Prostatectomy Da Vinci prostatectomy robot-assisted prostatectomy
robot-assisted laparoscopic radical prostatectomy
low-grade appendiceal mucinous neoplasm
CH conceived of the study and planed the design and performed the statistical analysis. GH participated in its design and coordination and helped to draft the manuscript and statistical analysis. TS and RB helped with data acquisition and statistical analysis. DT, SP, and BH participated in the design of the study, helped with data acquisition and supervision. MH conceived of the study, participated in data acquisition, coordination and supervision. All authors read and approved the final manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the local ethics committee (S-474/2014).
Informed consent was obtained from all individual participants included in the study.
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