Incidental appendectomy during mini incision post-partum sterilization (Chokchai technique): A prospective cross-sectional study.

Abstract

We aimed to determine the success rate of incidental appendectomy during post-partum sterilization (PPS) using the Chokchai technique and to compare the postoperative morbidity between patients who underwent this procedure with those who underwent simple PPS. Appendectomy during PPS was performed in 141 patients from 1 May 2012 to 30 April 2014. The control group consisted of 182 simple PPS patients. Primary outcomes were the success rate of the procedure and secondary outcomes were postoperative morbidity and complications. The success rate of this procedure was 98.6%. There was no statistically significant difference in intraoperative blood loss, hospital length of stay, or postoperative morbidity. Appendectomy added 7.5 min to the total procedure. Intravenous sedation requirements were 13.7% and 33.3% in the control and study groups, respectively. Pathologic evaluation of resected appendices revealed 15 abnormalities (10.8%), including two cases of periappendicitis (1.4%). When carried out by experienced surgeons and with appropriate anesthesia, incidental appendectomy during PPS is safe. The Chokchai technique (approach through a small periumbilical incision) achieved a high success rate and resulted in minimal scar. Incidental appendectomy not only prevents any future appendicitis but also helps to detect periappendicitis and treat its primary cause. However, this is an option for only selected patients who are clearly informed about the possible risks and benefits of the procedure.