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

BACKGROUND: Inversion of the appendix is an alternative to incidental appendectomy to prevent future appendicitis. This study investigated outcome and complications in a group of patients who underwent simple inversion of the appendix. PATIENTS AND METHODS: Inversion of the appendix was performed in 41 patients, including 21 women (51%) and 20 men (49%) (mean age, 48.7 years; range, 12–85 years). A simple inversion technique was used in 65% of patients. Twenty-nine patients had colonoscopy between 3 to 44 months after surgery (mean, 8 months), none for the sake of the study. RESULTS: During the follow up, none of patients developed intussusception or rectal bleeding. Colonoscopy demonstrated an absent appendix in 9 patients (31%). In the remaining 20 patients (69%), the inverted appendix persisted with no obvious change on visualized mucosa. CONCLUSION: Neither intussusception nor hemorrhage was observed after simple inversion. In our view, persistence of the appendix is a welcome event since the presence of the appendix may carry several benefits as it continues to work as a specialized organ, exerting an important physiological role in facilitating forward passage of colon contents, providing antibacterial functions and possibly playing a preventive role against development of colon and other cancers.