Department of General, Visceral, Thoracic, and Vascular Surgery, University Hospital, Ernst-Moritz-Arndt-University, Greifswald, Germany.
Langenbecks Arch Surg. 2010 Nov;395(8):1077-82. doi: 10.1007/s00423-010-0671-9. Epub 2010 Jun 26.
The aim of this study was to evaluate the feasibility, morbidity, and cost-effectiveness of the closure of the appendicular stump with a single non-absorbable polymeric clip compared with the closure of the appendicular stump with a stapler.
From January 2009 to December 2009, 82 patients, 31 males and 51 females (mean age of 35.4 years; range of 17 to 79 years), were included in this prospective, non-randomized trial. In 56 patients, the appendicular stump was closed by staplers, and in 26 patients, a single Hem-o-lok MLX polymeric clip was applied. The data collected included age, sex, time of surgery, costs, time of hospitalization, day-time of surgery, complications, and preoperative white blood count (WBC) and c-reactive protein (CRP).
There were no differences between the two groups regarding age, sex, WBC, CRP, and time of hospitalization. Time of surgery was longer in the clip group due to the introductory phase. Morbidity did not differ significantly and was highly acceptable in both groups. The costs of one set of Hem-o-lock clips were negligible compared to staplers (19.94 euros versus 356.43 euros).
The use of a single non-absorbable polymeric clip is easy to use even for surgical trainees; it is safe and cost-effective. We suggest the use of a single clip for the closure of the appendicular stump as the standard procedure in laparoscopic appendectomy whenever possible.
本研究旨在评估与使用吻合器闭合阑尾残端相比，使用单个不可吸收聚合物夹闭合阑尾残端的可行性、发病率和成本效益。
2009 年 1 月至 2009 年 12 月，82 名患者（31 名男性和 51 名女性，平均年龄 35.4 岁，年龄范围 17 岁至 79 岁）被纳入本前瞻性、非随机试验。在 56 名患者中，使用吻合器闭合阑尾残端，在 26 名患者中，使用单个 Hem-o-lok MLX 聚合物夹闭合阑尾残端。收集的数据包括年龄、性别、手术时间、成本、住院时间、手术日、并发症以及术前白细胞计数（WBC）和 C 反应蛋白（CRP）。
两组在年龄、性别、WBC、CRP 和住院时间方面无差异。由于引入阶段，夹闭组的手术时间较长。两组的发病率均无显著差异，且均具有较高的可接受性。与吻合器相比，一组 Hem-o-lock 夹的成本可以忽略不计（19.94 欧元对 356.43 欧元）。
即使对于外科受训者，单个不可吸收聚合物夹的使用也很容易；它是安全且具有成本效益的。我们建议在腹腔镜阑尾切除术中，只要可能，使用单个夹子作为闭合阑尾残端的标准程序。
