PAN Gang,XIE Guo-wei,LONG Fei-wu.Comparison of purse-string suture and absorbable clip clamping in closing appendiceal stump under laparoscope[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):444-446.
PAN Gang,XIE Guo-wei,LONG Fei-wu.Comparison of purse-string suture and absorbable clip clamping in closing appendiceal stump under laparoscope[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):444-446. DOI: 10.11659/jjssx.01E023009.
Comparison of purse-string suture and absorbable clip clamping in closing appendiceal stump under laparoscope
To compare the clinical effects of purse-string suture and absorbable clip clamping for closing appendiceal stump in laparoscopic appendectomy.
Methods
2
A total of 525 patients of acute appendicitis who underwent laparoscopic appendectomy were selected and divided into the embedded group (appendiceal stump was closed by ligation and embedded by purse-string suture) and the unembedded group (appendiceal stump was clamped twice by absorbable clips) according to treatment of appendiceal stump during the surgery.The surgical treatment and the duration of operation,hospital stay,hospitalization cost,incidence of complications 1 month after operation of two groups were compared.
Results
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Patients from both groups had successful laparoscopic appendectomy without severe postoperative complication.The duration of operation in the embedded group was longer than that in the unembedded group (t=8.313,P=0.001),the hospitalization cost in the unembedded group was significantly lower than that in the embedded group (t=2.591,P=0.013).There was no significant difference in the hospital stay or the incidence of postoperative complications (P>0.05).
Conclusion
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In laparoscopic appendectomy,the two methods for closing appendiceal stump are safe and effective.The absorbable clip for clamping appendiceal stump in appendectomy can be recommended as an operative method because it is more simple to operate and has shorter operation time,and does not increase the risk of postoperative complications.Laparoscopic purse-string suture of the appendiceal stump can save the treatment cost of patients,but has high requirements for the operation,and takes a long time of operation,which should be discreetly selected during the operation.
Goner RR,Heij HA,Eker HH,et al.Laparoscopic appendectomy:state of the art.Tailored approach to the application of laparoscopic appendectomy[J].Best Pract Res Clin Gastroenterol,2014,28(1):211-224.doi:10.1016/j.bpg.2013.11.016http://dx.doi.org/10.1016/j.bpg.2013.11.016.
Dai L,Shuai J.Laparoscopic versus open appendectomy in adults and children:a meta-analysis of randomized controlled trials[J].United European Gastroenterol J,2017,5(4):542-553.doi:10.1177/2050640 616661931http://dx.doi.org/10.1177/2050640616661931.
Di Saverio S,Podda M,De Simone B,et al.Diagnosis and treatment of acute appendicitis:2020 update of the WSES Jerusalem guidelines[J].World J Emerg Surg,2020,15(1):27.doi:10.1186/s13017-020-00306-3http://dx.doi.org/10.1186/s13017-020-00306-3.
Zaman S,Mohamedahmed AYY,Stonelake S,et al.Single-port laparoscopic appendicectomy versus conventional three-port approach for acute appendicitis in children:a systematic review and meta-analysis[J].Pediatr Surg Int,2021,37(1):119-127.doi:10.1007/s00383-020-04776-zhttp://dx.doi.org/10.1007/s00383-020-04776-z.
Wu SH,Shen YY,Wang J,et al.Conventional three-port laparoscopic appendectomy versus transumbilical and suprapubic single-incision laparoscopic appendectomy using only conventional laparoscopic instruments[J].Langenbecks Arch Surg,2022,407(8):3623-3629.doi:10.1007/s00423-022-02683-6http://dx.doi.org/10.1007/s00423-022-02683-6.
Jin SG,Cho SH,Kim KY,et al.Transumbilical single-incision laparoscopic-assisted appendectomy (TULAA) is useful in adults and young adolescents:comparison with multi-port laparoscopic appendectomy[J].Medicina,2019,55(6):248.doi:10.3390/medicina550 60248http://dx.doi.org/10.3390/medicina55060248.
Roviaro GC,Vergani C,Varoli F,et al.Video laparoscopic appendectomy:the current outlook [J].Surg Endosc,2006,20(10):1526-1530.doi:10.1007/s00464-005-0021-0http://dx.doi.org/10.1007/s00464-005-0021-0.
Raakow J,Klein D,Barutcu AG,et al.Single-port versus multiport laparoscopic surgery comparing long-term patient satisfaction and cosmetic outcome[J].Surg Endosc,2020,34(12):5533-5539.doi:10.1007/s00464-019-07351-3http://dx.doi.org/10.1007/s00464-019-07351-3.
Sauerland S,Jaschinski T,Neugebauer EA.Laparoscopic versus open surgery for suspected appendicitis[J].Cochrane Database Syst Rev,2010(10):CD001546.doi: 10.1002/14651858.CD001546.pub3http://dx.doi.org/10.1002/14651858.CD001546.pub3.
Ates M,Dirican A,Ince V,et al.Comparison of intracorporeal knot-tying suture (polyglactin) and titanium endoclips in laparoscopic appendiceal stump closure: a prospective randomized study [J].Surg Laparosc Endosc Percutan Tech, 2012,22(3):226-231.doi:10.1097/SLE.0b013e31824f25cdhttp://dx.doi.org/10.1097/SLE.0b013e31824f25cd.
Monrabal Lezama M,Casas MA,Angeramo CA,et al.Conversion from laparoscopic to open appendectomy:trends,risk factors and outcomes.A 15-year single-center analysis of 2193 adult patients[J].World J Surg, 2022,46(11):2642-2647.doi:10.1007/s00268-022-06670-2http://dx.doi.org/10.1007/s00268-022-06670-2.
Partecke LI,Kessler W,von Bernstorff W,et al.Laparoscopic appendectomy using a single polymeric clip to close theappendiceal stump[J].Langenbecks Arch Surg,2010,395(8):1077-1082.doi:10.1007/s00423-010-0671-9http://dx.doi.org/10.1007/s00423-010-0671-9.
Al-Temimi MH,Berglin MA,Kim EG,et al.Endostapler versus Hem-O-Lok clip to secure the appendiceal stump and mesoappendix during laparoscopic appendectomy[J].Am J Surg,2017,214(6):1143-1148.doi: 10.1016/j.amjsurg.2017.08.031http://dx.doi.org/10.1016/j.amjsurg.2017.08.031.
Förster S,Bernhardt J,Ludwig K.Appendectomy: open versus laparoscopic versus single port: evidence for choice of surgical procedure[J].Chirurg,2019,90(3):186-193.doi: 10.1007/s00104-018-0758-3http://dx.doi.org/10.1007/s00104-018-0758-3.