Abstract
BackgroundNowadays 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).MethodsThree 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.ResultsThere 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.ConclusionsLaparoscopic 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.
Highlights
Nowadays laparoscopy is used frequently in elective surgery and in abdominal emergencies, including acute appendicitis
The aim of the study was to present and compare the results of minimally invasive appendectomies performed with the use of endoscopic staplers, titanium endoclips and purse string invaginating sutures
The average hospital stay in this group was 3.6 days (SD = 1.4), the mean operation time was 62.9 min (SD = 13.5), complication rate was 5.6 % (9 cases: 1 relaparoscopy bacause of ileus caused by adhesions, 1 hematoma, 1 wound infection, 3 cases of prolonged drainage, 1 allergic rash caused by clindamycin, 2 cases of exacerbation of IHD)
Summary
Nowadays laparoscopy is used frequently in elective surgery and in abdominal emergencies, including acute appendicitis. Laparoscopic appendectomy is currently a well-established and widely accepted method [3, 4] It has a lot of advantages as compared with open approach technique, including less pain in the postoperative period, faster return to normal activity and work, shorter hospital stay and lower percentage of wound infections. Some authors point out a slightly higher rate of intra-abdominal abscesses and higher cost of laparoscopic procedure as compared with the open approach operation [5, 6]. It seems that both of these factors unfavorable for laparoscopy are influenced by the applied method of the appendicular stump closure. The optimal technique of the appendicular stump closure still seems to be controversial
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
