Document Detail

Appendectomy and the development of ulcerative colitis: results of a metaanalysis of published case-control studies.
MedLine Citation:
PMID:  10638578     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Numerous epidemiological studies have been performed to determine risk factors that might contribute to the development of ulcerative colitis (UC). Recent studies have focused on the role of appendectomy in the disease's pathogenesis. This report aims to review and analyze the degree of evidence from recent published studies. METHODS: Medline and Embase databases were scrutinized for studies published between 1987 and January 1999. Reference lists from published articles, reviews, and abstracts from major gastrointestinal (GI) meetings were also reviewed. All studies specifically designed to evaluate the association between appendectomy and UC were selected. Thirteen studies that satisfied our selection criteria were evaluated by metaanalysis. RESULTS: The 13 case-control studies collectively gathered evidence from 2770 patients with UC and 3352 controls. Combining the results of the individual studies gave an overall odds ratio of 0.307 (95% confidence interval [CI] = 0.249-0.377) in favor of appendectomy (p<0.0001). This suggests that appendectomy gives a 69% reduction in the risk of developing UC (95% CI = 62%-75%). The test for heterogeneity (of all 13 studies) was not significant (chi2 = 16.213, d.f. = 12, p>0.10). The influence of potential confounding factors (mainly smoking) on these results could be excluded. CONCLUSIONS: The review of the literature and the metaanalysis of the selected studies suggest that the inverse association between appendectomy and UC is strong and consistent. Further studies are needed to establish whether a causal relationship exists.
I E Koutroubakis; I G Vlachonikolis
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  95     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-02-04     Completed Date:  2000-02-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  171-6     Citation Subset:  IM    
Department of Gastroenterology, University Hospital of Heraklion, Greece.
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MeSH Terms
Appendectomy / adverse effects*
Case-Control Studies
Colitis, Ulcerative / etiology*
Confidence Intervals
Odds Ratio
Risk Factors
Comment In:
Am J Gastroenterol. 2000 Jul;95(7):1850-1   [PMID:  10926012 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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