Diffusion of laparoscopic appendectomies in Italy: A national audit

Abstract

A national audit focused on laparoscopic appendectomy was promoted by the Italian Association of Hospital Surgeons (ACOI). Four-hundred and sixty surgical practices received an e-mail questionnaire. Data concerning epidemiology, timetable, surgeon's age, selection of patients, laparotomic conversion, behaviour in the case of a normal appendix, and technical aspects were investigated. The response rate was 51.7%. The median number of appendectomies performed is 50–100 each year in a surgery ward. Laparoscopic operations are very common (93%), but mostly performed in less than 50% of the observed cases. There is no significant difference between the number of operations during the day vs. at night, and they are performed by a limited (<30%) group of surgeons, equally composed of physicians aged above and below 40. The majority of surgeons adopt an “all comers” policy regarding laparoscopic appendectomy, including selected older patients (>70 years old). There are no standard indications for conversion, while the behaviour in the presence of a normal appendix is generally removal. Even if laparoscopic appendectomy is not yet considered a gold standard, it is widely diffused in Italy, and the audit's data show different behaviours between subgroups.

Key words::

• Laparoscopic appendectomy
• technique
• diffusion assessment

Acknowledgments

Thanks for the collaboration of doctors Annecchiarico M, Antonini C, Capasso L, Caracino V, Carrara A, Contini P, De Vivo G, Feroci F, Forgione A, Guarino E, Guercioni G, Lazzaro L, Lotti M, Marchi D, Mazzei A, Mezzatesta P, Patriti A, Pernazza G, Ravazzoni F, Rota E, Sallustio P, Sartelli M, Sirchia M, members of the ACOI-LA survey promoting group (Young Surgeons Committee), to the Directional Board of ACOI and to all the colleagues who took the survey. Thanks also to Dr. Alison Townend for the precious language editing.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.