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Surgical Endoscopy

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Open Access 01-02-2020 | Wound Infection

Re-evaluation of purse string suture in laparoscopic appendectomy

Authors: Kamleshsingh Shadhu, Dadhija Ramlagun, Yao Wang, Xiaochun Ping, Tao Chen, Yanhui Zhu, Zekuan Xu

Published in: Surgical Endoscopy | Issue 2/2020

Abstract

Purpose

The aim of this study was to compare the outcomes of laparoscopic appendectomy (LA) using purse string invaginating sutures (PS) with those using intracorporeal knotting (IK) or Hem-o-lock polymeric clips (HL).

Methods

A total of 882 patients who underwent laparoscopic appendectomy from January 2015 to December 2017 were studied retrospectively. Of these, 538 patients used PS, 229 patients used IK and 115 patients used HL to close the appendiceal stump. Their demographic characteristics, intraoperative findings and postoperative complications were analysed retrospectively.

Results

There were similar percentages of complicated cases in all the groups (21.7% in PS vs. 21.4% in IK vs. 24.3% in HL, p = 0.803). The mean length of hospital stay was shorter in PS group when compared to IK or HL group (3.72 + 2.35 in PS vs. 4.41 + 2.40 in IK, 4.43 + 2.66 in HL, p < 0.05) as well as lower ASA scores (1.7 + 0.6 in PS vs. 1.8 + 0.6 in IK vs. 1.7 + 0.6 in HL, p < 0.05). The overall complication rates for the PS, the HL and the IK groups were 12.1, 8.7 and 9.2%, respectively. The rate of wound infection was higher in PS group for uncomplicated appendicitis (5.0% in PS vs. 2.8% in IK and 1.1% in HL, p = 0.129). Furthermore, there were no differences in the rate of intra-abdominal infection among the groups in both uncomplicated and complicated cases.

Conclusions

Based on our results, purse string suture failed to demonstrate better postoperative outcome in laparoscopic appendectomy and is no longer recommended by our institution as initial approach.

Original article open or laparoscopic appendectomy?

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Title: Re-evaluation of purse string suture in laparoscopic appendectomy
Authors: Kamleshsingh Shadhu
Dadhija Ramlagun
Yao Wang
Xiaochun Ping
Tao Chen
Yanhui Zhu
Zekuan Xu
Publication date: 01-02-2020
Publisher: Springer US
Keywords: Wound Infection
Appendicitis
Appendicitis
Appendectomy
Published in: Surgical Endoscopy / Issue 2/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-06828-5

ACC 2024 Congress

Springer Medicine

Re-evaluation of purse string suture in laparoscopic appendectomy

Abstract

Purpose

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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