BACKGROUND Diagnostic laparoscopy is often used when a patient is suspected of having acute appendicitis. The aim of this study was to assess the rate of other pathologies found during diagnostic laparoscopy for suspected acute appendicitis. METHODS This systematic search included studies with ≥100 patients who received laparoscopy for suspected acute appendicitis and reported on the histopathologic and other intra-abdominal findings. We performed a meta-analysis estimating the rate of other pathologies, and a sensitivity analysis excluding smaller cohorts (≤500 patients). Age groups, sex, specific findings, and geographic regions were investigated. Certainty of evidence was assessed with GRADE. RESULTS A total of 27 studies were included covering 25,547 patients and of these 793 had an unexpected pathology. The findings were benign pathology in the appendix (34%), malignancy (30%), gynecologic pathology (5%), gastrointestinal pathology (4%), or unspecified (27%). Meta-analysis showed an overall rate of unexpected findings of 3.5% (95% CI 2.7-4.3; moderate certainty), and the sensitivity analysis showed similar results. Malignancy found in the appendix when treating suspected acute appendicitis was 1.0% (95% CI 0.8-1.3%; high certainty). CONCLUSION The rate of other histopathological findings in patients with suspected acute appendicitis was low and a malignancy in appendix was found in 1% of patients.

中文翻译：

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疑似阑尾炎腹腔镜手术后很少报告其他病理：系统回顾和荟萃分析。

背景技术当患者怀疑患有急性阑尾炎时，通常使用诊断性腹腔镜检查。本研究的目的是评估在诊断性腹腔镜检查期间发现疑似急性阑尾炎的其他病变的发生率。方法 这项系统性检索包括 100 名以上因疑似急性阑尾炎接受腹腔镜检查的患者的研究，并报告了组织病理学和其他腹腔内发现。我们进行了一项荟萃分析，估计其他病理的发生率，并进行了排除较小队列（≤500 名患者）的敏感性分析。对年龄组、性别、具体发现和地理区域进行了调查。证据的确定性通过 GRADE 进行评估。结果 总共纳入 27 项研究，涵盖 25,547 名患者，其中 793 名患者出现意外病理。结果为阑尾良性病理（34%）、恶性肿瘤（30%）、妇科病理（5%）、胃肠道病理（4%）或未明确（27%）。荟萃分析显示意外发现的总体率为 3.5%（95% CI 2.7-4.3；中等确定性），敏感性分析显示类似的结果。治疗疑似急性阑尾炎时发现阑尾恶性肿瘤的率为 1.0%（95% CI 0.8-1.3%；高确定性）。结论 疑似急性阑尾炎患者其他组织病理学表现发生率较低，1%的患者发现阑尾恶性肿瘤。