Abstract
A randomized control trial was performed to evaluate the effectiveness and safety of absorbable polymeric clips for appendicular stump closure in laparoscopic appendectomy (LA). Patients were randomly enrolled into an experimental group (ligation of the appendicular base with Lapro-Clips, L-C group) or control group (ligation of the appendicular base with Hem-o-lok Clips, H-C group). We identified 1,100 patients who underwent LA between April 1, 2012 and February 3, 2015. Overall, 99 patients (9.0%, 99/1,100) developed a complication following LA (47 [8.5%] in the L-C group and 52 [9.5%] in the H-C group (P = 0.598). No statistically significant differences were observed in intra-abdominal abscesses, stump leakage, superficial wound infections, post-operative abdominal pain, overall adverse events, or the duration of the operations and hospital stays between the groups (all p > 0.05). Adverse risk factors associated with the use of absorbable clips in LA included body mass index ≥ 27.5 kg/m2, diabetes, American Society of Anesthesiologists degree ≥ III, gangrenous appendicitis, severe inflammation of the appendix base, appendix perforation, and the absence of peritoneal drainage. The results indicate that the Lapro-Clip is a safe and effective device for closing the appendicular stump in LA in select patients with appendicitis.
Highlights
Laparoscopic appendectomy (LA) is frequently performed to treat appendicitis [1]
There were no significant differences in patient age, gender, body mass index (BMI), or American Society of Anesthesiologists www.impactjournals.com/oncotarget (ASA) degree between the two groups (Table 1)
No significant differences in other adverse events were identified between the L-C and H-C groups (4.2% vs. 4.9%, P = 0.563)
Summary
Laparoscopic appendectomy (LA) is frequently performed to treat appendicitis [1]. It is a well-established surgical technique that has several advantages compared to open appendectomy (OA) such as a faster recovery time and reduced rate of infection [2, 3, 4]. Many studies have demonstrated that LA reduces surgical time, results in shorter hospital stays, and lowers the rate of complications compared to OA [2,3,4,5,6,7]. The use of absorbable polymeric clips (Lapro-Clips), which are widely used in laparoscopic cholecystectomy, was evaluated. We assessed the feasibility and safety of Lapro-Clips compared to non-absorbable polymeric clips (Hem-o-lok Clips) in a large number of patients who underwent LA
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