TPTh 4.15 Negative Appendicectomy Rate Audit in our Local Trust

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ID: 323919
2026
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Abstract
Abstract Background Acute appendicitis (AA) is a common surgical emergency, usually managed by laparoscopic appendicectomy. Negative appendicectomy rate (NAR) is defined as the removal of a histologically normal appendix in suspected appendicitis. The main clinical feature of appendicitis, right iliac fossa pain, has a broad differential diagnosis which can contribute to increased NAR. Therefore, in our trust, pre-operative imaging is required. The UK NAR was reported as 20% in the Right Iliac Fossa Pain Treatment (RIFT) study in 2020. Furthermore, a systematic review estimated a global NAR of 13% in 2023. An audit in 2021 in our Trust demonstrated a NAR of 3.05%, improving to 2.04% on re-audit. The aim is to evaluate our Trust’s current NAR comparing it with national, global and previous Trust data. Methods A retrospective review of histopathology reports was conducted for all emergency appendicectomies performed over a six-month period. Patients aged ≥16 years who underwent an appendicectomy with pre-operative diagnosis of AA were included. The NAR was calculated as a proportion of appendicectomies with normal histopathology. Results 150 patients (77 male, 73 female) underwent emergency appendicectomy. 7 patients (6 female, 1 male) had normal histopathology, resulting in a NAR of 4.67%, all had pre-operative imaging. Compared with our previous audit, the overall NAR increased (p=0.21). In patients aged 16-25, NAR increased to 11.54% but remained below the reported national rate. Conclusion Our Trust continues to demonstrate a lower NAR than national standards, though an increase from previous audits. This highlights the importance of ongoing clinical education.
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Authors Nesta Baxter, Saloni Rai, Anjana Kumar, Marcelle Macdonald-Leslie, Ridwan Hishi, Mihai Păduraru
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.467
URL
https://doi.org/10.1093/bjs/znag087.467
Keywords Keywords not found

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