Gonenc Murat, Gemici Eyup, Kalayci Mustafa Uygar, Karabulut Mehmet, Turhan Ahmet Nuray, Alis Halil
General Surgery Clinics, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
J Laparoendosc Adv Surg Tech A. 2012 Apr;22(3):231-5. doi: 10.1089/lap.2011.0335. Epub 2011 Dec 6.
The goal of the study was to compare the efficacy of two methods--intracorporeal knotting and metal endoclip application--for closure of the appendiceal stump during laparoscopic appendectomy in a specific group of patients with uncomplicated appendicitis.
The patients were randomized into two groups who had their appendiceal stump secured by intracorporeal knotting (Group 1) and metal endoclipping (Group 2). Primary outcome measure was postoperative complications, whereas secondary outcome measures were intraoperative complications, operative time, length of hospital stay, and re-admissions (including rehospitalizations and reoperations).
One hundred seven patients were prospectively recruited in a randomized study between December 2010 and May 2011. Group 1 and Group 2 included 46 and 61 patients, respectively. The rate of postoperative complications in Group 1 and Group 2 was 8.7% (4/46) and 4.9% (3/61) (P>.05). There were no significant differences between the groups in secondary outcome measures except the mean operative time (61.9 minutes versus 46.3 minutes, P=.0008).
The closure of the appendiceal stump by either intracorporeal knotting or metal endoclipping during laparoscopic appendectomy in uncomplicated appendicitis is safe with comparable morbidity and mortality rates.
本研究的目的是比较在一组患有单纯性阑尾炎的特定患者中，腹腔镜阑尾切除术期间两种闭合阑尾残端的方法——体内打结法和金属夹闭法——的疗效。
患者被随机分为两组，分别采用体内打结法（第1组）和金属夹闭法（第2组）固定阑尾残端。主要结局指标是术后并发症，次要结局指标是术中并发症、手术时间、住院时间和再次入院情况（包括再次住院和再次手术）。
在2010年12月至2011年5月期间，一项随机研究前瞻性纳入了107例患者。第1组和第2组分别包括46例和61例患者。第1组和第2组的术后并发症发生率分别为8.7%（4/46）和4.9%（3/61）（P>0.05）。除平均手术时间外（61.9分钟对46.3分钟，P = 0.0008），两组在次要结局指标方面无显著差异。
在单纯性阑尾炎的腹腔镜阑尾切除术中，采用体内打结法或金属夹闭法闭合阑尾残端是安全的，发病率和死亡率相当。
