Long-term outcome of simple inversion of the appendix as an alternativeto incidental appendectomy

Inversion of the appendix is an alternative to incidental appendectomy toprevent future appendicitis. This study investigated outcome andcomplications in a group of patients who underwent simple inversion of theappendix. Inversion of the appendix was performed in 41 patients, including21 women (51%) and 20 men (49%) (mean age, 48.7 year; range 12-85 years). Asimple inversion technique was used in 65% of patients. Twenty-nine patientshad colonoscopy between 3 to 44 months after surgery (mean, 8 months), nonefor the sake of study. During the follow-up, none of the patients developedintussusceptions or rectal bleeding. Colonoscopy demonstrated an absentappendix in 9 patients (31%). In the remaining 20 patients (69%), theinverted appendix persisted with no obvious change on visualized mucosa.Neither intussusception nor hemorrhage was observed after simple inversion.In our view, persistence of the appendix is a welcome event since thepresence of the appendix may carry several benefits as it continues to workas a specialized organ, exerting an important physiological role infacilitating forward passage of colon contents, providing antibacterialfunctions and possibly playing a preventive role against development of colonand other cancers. (author)