Clinicopathological analysis of Laparoscopically Removed Appendices of Nineteen Patients with Endometriosis

Yosuke Konno, Masataka Kudo, Daisuke Akashi, Satomi Kikawa, Shinya Nishi, Tatsuya Kato, Satoko Sudo, Takayuki Koshida, Yukio Wakui, Tosihiro Ookouchi, Hisanori Minakami, Noriaki Sakuragi
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2010 · vol. 26(2) , pp. 560–564 · doi:10.5180/jsgoe.26.560 · W2316189851
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study analyzed 19 patients with endometriosis who underwent laparoscopic appendectomy, finding appendiceal endometriosis in 12 cases and appendicitis in 4 cases, suggesting laparoscopic appendectomy is appropriate for abnormal appendices.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This paper analyzed clinicopathologic findings from laparoscopic appendices removed from 309 patients with endometriosis (2006–2008), focusing on 19 patients whose appendices had abnormal appearance and underwent appendectomy with pathological inspection. Abnormal appendiceal appearance was seen in 17/19, and among these, 16/17 (94.1%) had pathological abnormalities, including appendiceal endometriosis in 12 cases and appendicitis in 4, for an overall appendiceal endometriosis prevalence of 3.9% (12/309); the remaining 2 patients had chronic pelvic pain but no superficial abnormalities or pathological findings. The study reports that neither conversion to open surgery nor surgical complications requiring treatment were necessary, with the major caveat that conclusions are limited by the small subset (19 patients) selected for appendectomy based on intraoperative findings. This paper is centrally about endometriosis — it specifically examines the clinicopathological features and prevalence of appendiceal endometriosis among laparoscopically managed endometriosis patients.

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Abstract

Objective: Considered to be a cause of unexplained chronic pelvic pain, appendiceal endometriosis is relatively rare, accounting for only 3% of all pathologic lesions of this disorder. In this study, we analyzed the clinicopathologic findings of resected appendices with an abnormal appearance discovered during laparoscopic surgery for endometriosis.Patients and Methods: We performed laparoscopic surgery on 309 patients with endometriosis between January 2006 and December 2008 in Hokkaido University Hospital and its affiliated hospitals. Nineteen patients underwent laparoscopic appendectomy after careful pathologic inspection of their appendices.Results: An abnormal appendiceal appearance was found in 17 of 19 patients; the remaining 2 patients possessed no superficial appendiceal abnormalities but had chronic pelvic pein. Of 17 cases with abnormal appendiceal appearance, 16 (94.1%) had pathological abnormalities: appendiceal endometriosis was found in 12 cases and appendicitis in 4 cases. Two patients affected by chronic pelvic pain with normal appendiceal appearances had appendices with no pathological abnormalities. The prevalence of appendiceal endometriosis in this study was 3.9% (12/309). All patients with appendiceal endometriosis had endometriomas. Neither conversion to open surgery nor treatment for surgical complication was necessary.Conclusion: Laparoscopic appendectomy is an appropriate procedure for patients with endometriosis if they have abnormal appendiceal appearances. During laparoscopic surgery for endometriosis, especially in the case of endometrioma, close observation of the appendix may allow surgeons to remove endometriotic lesions more thoroughly.
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Abstract

Objective: Considered to be a cause of unexplained chronic pelvic pain, appendiceal endometriosis is relatively rare, accounting for only 3% of all pathologic lesions of this disorder. In this study, we analyzed the clinicopathologic findings of resected appendices with an abnormal appearance discovered during laparoscopic surgery for endometriosis. Patients and Methods: We performed laparoscopic surgery on 309 patients with endometriosis between January 2006 and December 2008 in Hokkaido University Hospital and its affiliated hospitals. Nineteen patients underwent laparoscopic appendectomy after careful pathologic inspection of their appendices.

Results

An abnormal appendiceal appearance was found in 17 of 19 patients; the remaining 2 patients possessed no superficial appendiceal abnormalities but had chronic pelvic pein. Of 17 cases with abnormal appendiceal appearance, 16 (94.1%) had pathological abnormalities: appendiceal endometriosis was found in 12 cases and appendicitis in 4 cases. Two patients affected by chronic pelvic pain with normal appendiceal appearances had appendices with no pathological abnormalities. The prevalence of appendiceal endometriosis in this study was 3.9% (12/309). All patients with appendiceal endometriosis had endometriomas. Neither conversion to open surgery nor treatment for surgical complication was necessary.

Conclusion

Laparoscopic appendectomy is an appropriate procedure for patients with endometriosis if they have abnormal appendiceal appearances. During laparoscopic surgery for endometriosis, especially in the case of endometrioma, close observation of the appendix may allow surgeons to remove endometriotic lesions more thoroughly. Patients and Methods: We performed laparoscopic surgery on 309 patients with endometriosis between January 2006 and December 2008 in Hokkaido University Hospital and its affiliated hospitals. Nineteen patients underwent laparoscopic appendectomy after careful pathologic inspection of their appendices.

Results

An abnormal appendiceal appearance was found in 17 of 19 patients; the remaining 2 patients possessed no superficial appendiceal abnormalities but had chronic pelvic pein. Of 17 cases with abnormal appendiceal appearance, 16 (94.1%) had pathological abnormalities: appendiceal endometriosis was found in 12 cases and appendicitis in 4 cases. Two patients affected by chronic pelvic pain with normal appendiceal appearances had appendices with no pathological abnormalities. The prevalence of appendiceal endometriosis in this study was 3.9% (12/309). All patients with appendiceal endometriosis had endometriomas. Neither conversion to open surgery nor treatment for surgical complication was necessary.

Conclusion

Laparoscopic appendectomy is an appropriate procedure for patients with endometriosis if they have abnormal appendiceal appearances. During laparoscopic surgery for endometriosis, especially in the case of endometrioma, close observation of the appendix may allow surgeons to remove endometriotic lesions more thoroughly. © 2010 Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy Favorites & Alerts Recently viewed articles

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endometriosisendometriomachronic_pelvic_pain

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