Top

World Journal of Emergency Surgery

Published in:

Open Access 01-12-2016 | Research article

Comparison of the results of laparoscopic appendectomies with application of different techniques for closure of the appendicular stump

Authors: Marcin Strzałka, Maciej Matyja, Kazimierz Rembiasz

Published in: World Journal of Emergency Surgery | Issue 1/2016

Abstract

Background

Nowadays laparoscopy is used frequently not only in elective surgery but also in abdominal emergencies, including acute appendicitis. There are several techniques used to close the appendicular stump during laparoscopic appendectomy. The aim of the study was to present and compare the results of minimally invasive appendectomies performed with the use of endoscopic staplers (group A), titanium endoclips (group B) and invaginating sutures (group C).

Methods

Three hundred seven patients (mean age = 35.6; SD = 15.9; 178 males,129 females) operated on laparoscopically for acute appendicitis from January 2010 to December 2014 at our department were included in the study. We reviewed retrospectively patients’ data including: age, sex, duration of the surgical procedure and hospital stay, mortality, intraoperative and postoperative complication rates in all analyzed groups.

Results

There were 102 patients in group A (mean age = 35.8;SD = 15.4; 57 males, 45 females). The average hospital stay in this group was 4.3 days (SD = 1.7), average operation time was 62.0 min (SD = 15), postoperative complication rate was 5.9 %. There were 160 patients in group B (mean age = 35.0; SD = 16.3; 96 males, 64 females). The average hospital stay in this group was 3.6 days (SD = 1.4), average operation time was 62.9 min (SD = 13.5), postoperative complication rate was 5.6 %. There were 45 patients in group C (mean age =37.3; SD = 15.8; 25 males, 20 females). The average hospital stay in this group was 4.6 days (SD = 2.0), average operation time was 73.9 min (SD = 20.8), postoperative complication rate was 6.7 %. There were no intraoperative complications and no mortality in all compared groups of patients operated on laparoscopically for acute appendicitis.

Conclusions

Laparoscopic appendectomies with application of different techniques for closure of the appendicular stump are useful and safe. In our study the shortest hospital stay and lowest complication rate were observed in patients operated with the use of titanium endoclips. The longest hospital stay and operation time and the highest complication rate was associated with the use of invaginating sutures.

Bobrzyński A, Budzyński A, Strzałka M. Laparoscopy in abdominal emergencies. Przegl Lek. 2002;59(10):873–6.PubMed

Strzałka M, Bobrzyński A. Laparoskopia w leczeniu ostrych schorzeń jamy brzusznej. Wideochir Inne Tech Malo Inwazyjne. 2008;3(1):1–9.

Strzałka M, Bobrzyński A, Budzyński A, Gwóźdź A. Usunięcie wyrostka robaczkowego techniką klasyczną czy laparoskopową? Wideochir Inne Tech Malo Inwazyjne. 2009;4(3):110–4.

Sauerland S, Jaschinski T, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2010;6(10), CD001546.

Krisher SL, Browne A, Dibbins A, Tkacz N, Curci M. Intra-abdominal abscess after laparoscopic appendectomy for perforated appendicitis. Arch Surg. 2001;136:438–41.CrossRefPubMed

Sporn E, Petroski GF, Mancini GJ, Astudillo JA, Miedema BW, Thaler K. Laparoscopic appendectomy—is it worth the cost? Trend analysis in the US from 2000 to 2005. J Am Coll Surg. 2009;208:179–85.CrossRefPubMed

Sajid MS, Rimple J, Cheek E, Baig MK. Use of endo-GIA versus endo-loop for securing the appendicular stump in laparoscopic appendicectomy: a systematic review. Surg Laparosc Endosc Percutan Tech. 2009;19:11–5.CrossRefPubMed

Kazemier G, in’t Hof KH, Saad S, Bonier HJ, Sauerland S. Securing the appendiceal stump in laparoscopic appendectomy: evidence for routine stapling? Surg Endosc. 2006;20:1473–6.CrossRefPubMed

Costa-Navarro D, Jiménez-Fuertes M, Illán-Riquelme A. Laparoscopic appendectomy: quality care and cost-effectiveness for today’s economy. World J Emerg Surg. 2013;8:45.CrossRefPubMedPubMedCentral

10.

Partecke LI, Kessler W, von Bernstorff W, Diedrich S, Heidecke CD, Patrzyk M. Laparoscopic appendectomy using a single polymeric clip to close the appendicular stump. Langenbecks Arch Surg. 2010;395:1077–82.CrossRefPubMed

11.

Delibegovic S, Matovic E. Hem-o-lok plastic clips in securing of the base of the appendix during laparoscopic appendectomy. Surg Endosc. 2009;23:2851–4.CrossRefPubMed

12.

Gonenc M, Gemici E, Kalayci MU, Karabulut M, Turhan AN, Alis H. Intracorporeal knotting versus metal endoclip application for the closure of the appendiceal stump during laparoscopic appendectomy in uncomplicated appendicitis. J Laparoendosc Adv Surg Tech A. 2012;8(3):231–5.CrossRef

13.

Alis H, Gonenc M, Deniztas C, Kapan S, Turhan AN. Metal endoclips for the closure of the appendiceal stump in laparoscopic appendectomy. Tech Coloproctol. 2012;16(2):139–41.CrossRefPubMed

14.

Rickert A, Bönninghoff R, Post S, Walz M, Runkel N, Kienle P. Appendix stump closure with titanium clips in laparoscopic appendectomy. Langenbecks Arch Surg. 2012;397(2):327–31.CrossRefPubMedPubMedCentral

15.

Ates M, Dirican A, Ince V, Ara C, Isik B, Yilmaz S. Comparison of intracorporeal knot-tying suture (polyglactin) and titanium endoclips in laparoscopic appendiceal stump closure: a prospective randomized study. Surg Laparosc Endosc Percutan Tech. 2012;22(3):226–31.CrossRefPubMed

16.

Gomes CA, Junior CS, de Peixoto RO, Netto JM, Gomes CC, Gomes FC. Appendiceal stump closure by metal endoclip in the management of complicated acute appendicitis. World J Emerg Surg. 2013;8:35.CrossRefPubMedPubMedCentral

17.

Di Saverio S, Mandrioli M, Sibilio A, Smerieri N, Lombardi R, Catena F, et al. A cost-effective technique for laparoscopic appendectomy: outcomes and costs of a case–control prospective single-operator study of 112 unselected consecutive cases of complicated acute appendicitis. J Am Coll Surg. 2014;218(3):e51–65. doi:10.1016/j.jamcollsurg.2013.12.003. Epub 2013 Dec 19.CrossRefPubMed

18.

Rembiasz K, Bobrzyński A, Budzyński A, Strzałka M, Gwóźdź A, Migaczewski M, et al. Analysis of complications of laparoscopic management of abdominal diseases related to extended indications. Wideochir Inne Tech Malo Inwazyjne. 2010;5(2):53–9.

19.

Shaikh FM, Baiwa R, McDonnell CO. Management of appendiceal stump in laparoscopic appendectomy – clips or ligature: a systematic review and meta-analysis. J Laparoendosc Adv Surg Tech. 2015;25(1):21–7.CrossRef

20.

Di Saverio S, Mandrioli M, Birindelli A, Biscardi A, Di Donato L, Gomes CA, et al. Single incision laparoscopic appendectomy with a “Low Cost” technique and surgical glove port: “How To Do It” with comparison of the outcomes and costs in a consecutive single-operator series of 45 cases. J Am Coll Surg. 2015. doi:10.1016/j.jamcollsurg.2015.11.019.PubMed

Title: Comparison of the results of laparoscopic appendectomies with application of different techniques for closure of the appendicular stump
Authors: Marcin Strzałka
Maciej Matyja
Kazimierz Rembiasz
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: World Journal of Emergency Surgery / Issue 1/2016
Electronic ISSN: 1749-7922
DOI: https://doi.org/10.1186/s13017-015-0060-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Comparison of the results of laparoscopic appendectomies with application of different techniques for closure of the appendicular stump

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2016

Erratum to: 2016 WSES guidelines on acute calculous cholecystitis

Validity of predictive factors of acute complicated appendicitis

Damage control operations in non-trauma patients: defining criteria for the staged rapid source control laparotomy in emergency general surgery

Management of traumatic wounds in the Emergency Department: position paper from the Academy of Emergency Medicine and Care (AcEMC) and the World Society of Emergency Surgery (WSES)

Risk factors for delayed neuro-surgical intervention in patients with acute mild traumatic brain injury and intracranial hemorrhage

Surgical treatment of multiple rib fractures and flail chest in trauma: a one-year follow-up study