Incidental appendectomy – standard or unnecessary additional trauma in surgery for colorectal cancer? A retrospective analysis of histological findings in 380 specimens


Dr Ruth Exner, Medizinische Universität Wien, Klinik für Chirurgie, AKH Wien, Währinger Gürtel 18-20, 1090 Wien, Austria.


Background  Incidental appendectomy is a frequent but non-standard procedure during surgery for colorectal cancer. Incidental appendectomy during colorectal resections is performed at the discretion of the operating surgeon.

Method  This retrospective study used data from 1352 consecutive patients who underwent surgery for colorectal cancer between 1993 and 2009 at the Medical University of Vienna. The authors evaluated histopathological results of appendices removed incidentally. In addition, complications and costs of the additional intervention were analyzed.

Results  Appendectomy had been performed in 314 (23.22%) patients because of appendicitis. Incidental appendectomy had been performed in 380 (28.11%) patients: 86 (22.63%) had a histologically completely normal appendix, a pathologic alteration was found in 289 (76.05%) and a neoplasm was found in seven (1.84%). No complications occurred from the additional surgical procedure. The costs and time effort were negligible.

Conclusion  Incidental appendectomy is a safe procedure and can be integrated into surgery for colorectal carcinoma to avoid future complications. Pathological findings of the appendix, including neoplasm, are frequent but the clinical relevance remains questionable.