Application of different methods for stump closure in laparoscopic appendectomy

Abstract

Background Appendicular stump closure is the most critical event in laparoscopic appendectomy. The aim of the present study was to verify the effectiveness of stump closure using the endostapler, extracorporeal sliding knot, and intracorporeal suture in different stages of appendicitis. Materials and methods This prospective study was conducted from July 2014 to March 2016 and included 135 patients who underwent laparoscopic appendectomy. We reviewed patients’ demography, operative time, hospital stay, and complications in different stump closure techniques. Results The stapler group consisted of 45 patients − 27 men and 18 women. The mean age was 33.5 years, mean operation time was 56.4 min, complication rate was 6.6%, and average hospital stay was 1.73 days. The extracorporeal sliding knot group consisted of 43 patients − 24 men and 19 women. The mean age was 36 years, mean operation time was 71.5 min, complication rate was 2.3%, and average hospital stay was 1.8 days. The intracorporeal suture group consisted of 47 patients − 21 men and 26 women. The mean age was 33.6 years, mean operation time was 84.3 min, complication rate was 4.2%, and average hospital stay was 2.3 days. Conclusion Laparoscopic staplers had the least hospital stay and the shortest operative time, inspite of the insignificant difference regarding the complication rates among the three groups. Although the application of the suture knot and the extracorporeal knot had the longest surgical procedure time, they were more suitable because of the economic conditions of our country.