BACKGROUND:Laparoscopic appendectomy is a well-described surgical technique. However, concerns still exist regarding whether the closure of the appendiceal stump should be done with a clip, an endoloop, staples, or other techniques. Therefore, several modifications to the original technique with new materials have been introduced for appendiceal stump closure. The aim of this study was to compare intracorporeal (polyglactin) knot-tying suture with titanium endoclips in appendiceal stump closure during laparoscopic appendectomy. METHODS: The study was carried out as a prospective randomized clinical trial between April 2010 and February 2011. Patients with a presentation of appendicitis were included into the study. Two groups were defined-patients with the titanium endoclip and patients with the knot-tying (polyglactin) suture. The results in terms of operating time, complication rates, and hospital stay were analyzed. RESULTS:Sixty-one patients who underwentlaparoscopic appendectomy were enrolled in the titanium endoclip group (n=30) or the knot-tying (polyglactin) suture group (n=31). No statistically significant differences were detected between the groups in terms of the distribution of age, sex percentage, appendix localization, and histopathologic diagnosis (P>0.05). One patient required a second operation on postoperative day 10 because of intraperitoneal abscess. The mean operative time for the endoclip group (41.27 ± 12.2 min) was shorter than that for the knot-tying group (62.81 ± 15.4 min) (P=0.001). No statistically significant differences were detected between the groups in terms of hospital stay, follow-up time, and preoperative and postoperative complications (P>0.05). CONCLUSIONS: In laparoscopic appendectomy, using a titanium endoclip for optimizing and controlling the appendiceal stump closure is safe and is associated with shorter operation time. This also simplifies the procedure, so it can be a useful alternative to intracorporeal knot-tying for appendiceal stump closure.
RCT Entities:
BACKGROUND: Laparoscopic appendectomy is a well-described surgical technique. However, concerns still exist regarding whether the closure of the appendiceal stump should be done with a clip, an endoloop, staples, or other techniques. Therefore, several modifications to the original technique with new materials have been introduced for appendiceal stump closure. The aim of this study was to compare intracorporeal (polyglactin) knot-tying suture with titanium endoclips in appendiceal stump closure during laparoscopic appendectomy. METHODS: The study was carried out as a prospective randomized clinical trial between April 2010 and February 2011. Patients with a presentation of appendicitis were included into the study. Two groups were defined-patients with the titanium endoclip and patients with the knot-tying (polyglactin) suture. The results in terms of operating time, complication rates, and hospital stay were analyzed. RESULTS: Sixty-one patients who underwent laparoscopic appendectomy were enrolled in the titanium endoclip group (n=30) or the knot-tying (polyglactin) suture group (n=31). No statistically significant differences were detected between the groups in terms of the distribution of age, sex percentage, appendix localization, and histopathologic diagnosis (P>0.05). One patient required a second operation on postoperative day 10 because of intraperitoneal abscess. The mean operative time for the endoclip group (41.27 ± 12.2 min) was shorter than that for the knot-tying group (62.81 ± 15.4 min) (P=0.001). No statistically significant differences were detected between the groups in terms of hospital stay, follow-up time, and preoperative and postoperative complications (P>0.05). CONCLUSIONS: In laparoscopic appendectomy, using a titanium endoclip for optimizing and controlling the appendiceal stump closure is safe and is associated with shorter operation time. This also simplifies the procedure, so it can be a useful alternative to intracorporeal knot-tying for appendiceal stump closure.
Authors: Gurdeep S Mannu; Maria K Sudul; Joao H Bettencourt-Silva; Elspeth Cumber; Fangfang Li; Allan B Clark; Yoon K Loke Journal: Cochrane Database Syst Rev Date: 2017-11-13
Authors: Alexander Rickert; Colin M Krüger; Norbert Runkel; Andreas Kuthe; Jörg Köninger; Boris Jansen-Winkeln; Carsten N Gutt; Daniel R Marcus; Brian Hoey; Moritz N Wente; Peter Kienle Journal: BMC Surg Date: 2015-07-17 Impact factor: 2.102
Authors: Ramon R Gorter; Hasan H Eker; Marguerite A W Gorter-Stam; Gabor S A Abis; Amish Acharya; Marjolein Ankersmit; Stavros A Antoniou; Simone Arolfo; Benjamin Babic; Luigi Boni; Marlieke Bruntink; Dieuwertje A van Dam; Barbara Defoort; Charlotte L Deijen; F Borja DeLacy; Peter Mnyh Go; Annelieke M K Harmsen; Rick S van den Helder; Florin Iordache; Johannes C F Ket; Filip E Muysoms; M Mahir Ozmen; Michail Papoulas; Michael Rhodes; Jennifer Straatman; Mark Tenhagen; Victor Turrado; Andras Vereczkei; Ramon Vilallonga; Jort D Deelder; Jaap Bonjer Journal: Surg Endosc Date: 2016-09-22 Impact factor: 4.584