Bozkurt Mehmet Abdussamet, Ünsal Mustafa Gökhan, Kapan Selin, Kankaya Burak, Kalaycı Mustafa Uygar, Alış Halil
Department of General Surgery, Dr. Sadi Konuk Education and Research Hospital , Istanbul, Turkey .
J Laparoendosc Adv Surg Tech A. 2014 Aug;24(8):571-3. doi: 10.1089/lap.2013.0543. Epub 2014 Jul 9.
Closure of the appendiceal stump (CAS) is the most crucial part of appendectomy procedures because most of the complications occur by a leak of the stump. The aim of this retrospective clinical study is to emphasize two different methods (metal clip and Hem-o-lok(®) [Teleflex Medical, Research Triangle Park, NC] clip) for CAS.
The cases were divided into two subgroups according to the type of CAS. Subgroups were compared with each other according to age, intraabdominal abscess formation, operation duration, and complication rate.
No intraoperative complications were seen in either subgroup. There were 22 postoperative complications in the metal clip subgroup (13 intraabdominal abscesses, 9 wound infections) and 8 postoperative complications in the Hem-o-lok clip subgroup (five intraabdominal abscesses, three wound infections). The cost of the closure was $7 for the metal clip group and $50 for the Hem-o-lok clip group.
The use of Hem-o-lok clips and metal clip for CAS in laparoscopic appendectomy is a feasible, safe, and cost-effective procedure in patients with a mild to moderately inflamed appendix base of less than 10 mm in diameter.
阑尾残端闭合（CAS）是阑尾切除手术中最关键的部分，因为大多数并发症是由残端渗漏引起的。这项回顾性临床研究的目的是强调两种不同的CAS方法（金属夹和Hem-o-lok®[泰利福医疗公司，北卡罗来纳州三角研究园]夹）。
根据CAS类型将病例分为两个亚组。根据年龄、腹腔内脓肿形成、手术时间和并发症发生率对亚组进行相互比较。
两个亚组均未出现术中并发症。金属夹亚组有22例术后并发症（13例腹腔内脓肿，9例伤口感染），Hem-o-lok夹亚组有8例术后并发症（5例腹腔内脓肿，3例伤口感染）。金属夹组的闭合成本为7美元，Hem-o-lok夹组为50美元。
对于直径小于10毫米的轻度至中度炎症阑尾根部患者，在腹腔镜阑尾切除术中使用Hem-o-lok夹和金属夹进行CAS是一种可行、安全且具有成本效益的手术。
