Comparison of three techniques for appendiceal stump closure during laparoscopy

Eyüp Gemici; Turgut Dönmez; Ahmet Sürek; Seymur Abdullayev; Hüsnü Aydın; Mehmet Abdussamet Bozkurt; Mehmet Karabulut

doi:10.28982/josam.781614

Authors

Eyüp Gemici https://orcid.org/0000-0001-6769-3305
Turgut Dönmez https://orcid.org/0000-0003-3095-2195
Ahmet Sürek https://orcid.org/0000-0002-5192-2481
Seymur Abdullayev https://orcid.org/0000-0003-2102-0169
Hüsnü Aydın https://orcid.org/0000-0002-3364-3649
Mehmet Abdussamet Bozkurt https://orcid.org/0000-0003-3222-9363
Mehmet Karabulut Health Science University, Bakirkoy Dr Sadi Konuk Education and Research Hospital, Department of General Surgery https://orcid.org/0000-0002-1889-5637

DOI:

https://doi.org/10.28982/josam.781614

Keywords:

acute appendicitis, laparoscopic appendectomy, laparoscopic purse string, Hem-o-lok clip

Abstract

Aim: Laparoscopic appendectomy is the gold standard treatment of acute appendicitis. However, there is no consensus about the technique to apply when closing the appendix stump. This study compares three techniques to close the appendix stump: Laparoscopic purse-string suture (LPS), metal clips, and Hem-o-lok clips. The aim is to evaluate the advantages, safety, and costs of these three methods. Methods: We conducted a retrospective cohort study which included 220 patients who underwent laparoscopic appendectomy operations for acute appendicitis between May 2017 and December 2019. The cases were divided into three groups and evaluated. Group A received LPS, group B received metal clips, and group C received Hem-o-lok clips. The demographic features of the patients, American Society of Anesthesiology (ASA) scores, duration of surgery, postoperative complications, hospital stay, and cost were evaluated retrospectively from patient files. Results: There were 79 patients in group A, 91 patients in group B, and 50 patients in group C. There was no difference between the groups with respect to demographic features, ASA physiological state scores, and laboratuary values. The operation time and postoperative complication rates did not differ between groups (P>0.05). Group C had longer hospital stays (P=0.001), and group A had lower costs (P=0.001). Conclusion: In the laparoscopic appendectomy technique, the use of LPS for appendix stump closure is safe and effective. Furthermore, technical consumables and hospital treatment costs are significantly reduced.

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