2164 Utilization of Appendectomy in the Surgical Treatment of Endometriosis.

There is paucity of data and lack of expert consensus on the role of appendectomy in surgical treatment of endometriosis. We seek to describe the nationwide practice of appendectomy for endometriosis, and analyze its safety profile and surgical outcomes. Retrospective cohort. Comparisons were made using Chi-squared for proportions or t-test for means. 708 United States hospitals in the participating in American College of Surgeons National Surgical Quality Improvement Program. Patients undergoing any surgery for endometriosis 2014-2017. Surgeries performed for endometriosis were identified by ICD-9/10 diagnosis code. Utilization of appendectomy was determined by querying these endometriosis surgeries for the CPT procedure codes for appendectomy. We identified 14,776 endometriosis surgeries. Appendectomy was performed in 545 (3.7%) of all surgeries for endometriosis; of these, 352 (64.6%) were performed by gynecologists and 193 (35.4%) by general surgeons. Overall risk of perioperative complications in surgery for endometriosis did not differ with utilization of appendectomy (5.0% appendectomy vs 4.6% no appendectomy, p = 0.67); moreover, the incidence of complications with appendectomy did not differ by surgeon type (5.4% gynecologist vs 4.9% general surgeon, p = 1.0). Utilization of appendectomy was associated with increased operative time (149.0 ± 105.0 vs 117.6 ± 67.7 minutes, p = <0.001) and length of stay (1.9 ± 2.5 vs 1.3 ± 2.2 days, p = <0.001), but lower average work relative value unit (wRVU) compared to endometriosis surgery without appendectomy (14.5 ± 6.5 vs 15.5 ± 4.0, p = <0.001). Appendectomy for endometriosis is rarely performed; when utilized, it is performed by both gynecologists and general surgeons. Utilization of was not associated with differences in overall in risk profile. However, appendectomy for endometriosis was associated with longer operative times and length of stay, and lower reimbursement. [ABSTRACT FROM AUTHOR]