Stump Closure Techniques in Laparoscopic Appendectomy: Analysis of 511 Patients:  Stump Closure Techniques in Laparoscopic Appendectomy

Şener Balas; Abdurrahman  Başpınar; .Bourak  Chousein; Abdullah Fatih  Sancak; Serkan Demir; Harun Karabacak

doi:10.5281/zenodo.10021033

Authors

Şener Balas Ankara Başkent Üniversitesi Hastanesi
Abdurrahman Başpınar Sbü Ankara Resarch ad Teaching Hospital General Surgery https://orcid.org/0000-0002-6449-4519
.Bourak Chousein ,Etlik City Hospital, General Surgery, Ankara, TURKEY https://orcid.org/0000-0003-4725-2881
Abdullah Fatih Sancak Etlik City Hospital, General Surgery, Ankara, TURKEY https://orcid.org/0009-0008-7750-1766
Serkan Demir ,Etlik City Hospital, General Surgery, Ankara, TURKEY https://orcid.org/0009-0008-1187-7883
Harun Karabacak Etlik City Hospital, General Surgery, Ankara, TURKEY https://orcid.org/0000-0002-8905-0455

DOI:

https://doi.org/10.5281/zenodo.10021033

Keywords:

Laparoscopy,, Appendectomy,, Stump

Abstract

AIM : Laparoscopic appendectomy has become an accepted method for the management of acute appendicitis. Closing the appendiceal stump is a crucial step in this operation. Although various methods for stump closure have been described, there is no evidence-based consensus in the literature. In our study, we aimed to compare the stump closure techniques used in laparoscopic appendectomy surgeries performed in our clinic.

METHODS: Laparoscopic appendectomy operations conducted between 2017 and 2021 were retrospectively examined. Demographic information, operation durations, length of hospital stays, Alvarado scores, intraoperative findings, readmissions, reoperations, intra-abdominal abscesses, wound site infections, stump leakage, ileus, and other complications were evaluated for a total of 511 patients.

RESULTS: Of the patients, 193 (37.8%) were female, and 318 (62.2%) were male. The mean age was 37.84 years, with an Alvarado score of 6.89, and an average hospital stay of 1.45 days. Stump closure methods were as follows: 208 (40.7%) patients with Hem-o-lok polymer clips (HLK), 59 (11.5%) patients with endo-stapler (EDS), 111 (21.7%) patients with manually inserted loops (EYL), and 133 (26%) patients with endoloop (EDL). According to the method, the average operation durations were determined as 48.28 minutes in the HLK group, 51.69 minutes in the EDS group, 48.23 minutes in the EYL group, and 48.80 minutes in the EDL group. Hospital stays were observed to be the longest in the EDS group with an average of 1.73 days based on the stump closure method. Complications developed in 2 patients in the HLK group, 2 patients in the EDS group, and 1 patient in both the EYL and EDL groups.

CONCLUSION: The examined stump closure methods appeared to be similar in terms of application and complications. Although the study included a large series of patients, these findings need to be confirmed through prospective randomized controlled trials

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Stump Closure Techniques in Laparoscopic Appendectomy: Analysis of 511 Patients