Department of Gastroenterologycal Surgery, Dicle University School of Medicine, 21280, Sur/Diyarbakır, Turkey.
Department of General Surgery, Batman Regional Hospital, Batman, Turkey.
Langenbecks Arch Surg. 2024 Mar 8;409(1):89. doi: 10.1007/s00423-024-03281-4.
Polymeric clips (Hem-o-lok ligation system) are now widely used to securing the base of the appendix during laparoscopic appendectomy. Studies comparing the use of single or double hem-o-lok clips are limited. The aim of this study was to compare the reliability of a single hem-o-lok clips with a double hem-o-lok clips for closure of an appendiceal stump.
This prospective randomized study includes patients from two centers who underwent laparoscopic appendectomy with the diagnosis of appendicitis between September 2020 and March 2023. Demographic, operative and clinical outcomes of the use of single or double hem-o-lok clips for closure of the appendiceal stump were compared. Factors affecting long postoperative hospital stay were investigated using univariate and multivariate analyzes.
One hundred forty two (48.3%) patients in the single hem-o-lok arm and 152 (51.7%) patients in the double hem-o-lok arm were included in the analysis.The shortest operative time was noted in the single hem-o-lok group (52.1 ± 19.9 versus 61.6 ± 24.9 min, p < 0.001). The median hospital stay was 1 day (range 1-10) in the single hem-o-lok group and 1 day (range 1-12) in the double hem-o-lok group, and was shorter in the single hem-o-lok arm (1.61 ± 1.56 vs 1.84 ± 1.69, p = 0.019). Based on multivariate analysis, drain placement was identified as an independent predictive factor for long hospital stay.
The use of single hem-o-lok clips for appendiceal stump closure during laparoscopic appendectomy is safe and effective. Trial registration NCT04387370 ( http://www.
gov ).
聚合物夹（Hem-o-lok 结扎系统）现在广泛用于腹腔镜阑尾切除术中固定阑尾根部。比较使用单夹或双夹的研究有限。本研究旨在比较单夹和双夹Hem-o-lok 夹闭合阑尾残端的可靠性。
这项前瞻性随机研究纳入了 2020 年 9 月至 2023 年 3 月期间在两个中心因阑尾炎行腹腔镜阑尾切除术的患者。比较了单夹或双夹Hem-o-lok 夹闭合阑尾残端的手术和临床结果。使用单变量和多变量分析调查影响术后住院时间延长的因素。
142 例（48.3%）患者在单夹 Hem-o-lok 组，152 例（51.7%）患者在双夹 Hem-o-lok 组被纳入分析。单夹 Hem-o-lok 组的手术时间最短（52.1±19.9 分钟 vs. 61.6±24.9 分钟，p<0.001）。单夹 Hem-o-lok 组的中位住院时间为 1 天（范围 1-10 天），双夹 Hem-o-lok 组为 1 天（范围 1-12 天），单夹 Hem-o-lok 组更短（1.61±1.56 天 vs. 1.84±1.69 天，p=0.019）。基于多变量分析，引流管的放置被确定为延长住院时间的独立预测因素。
在腹腔镜阑尾切除术中使用单夹 Hem-o-lok 夹闭合阑尾残端是安全有效的。试验注册 NCT04387370（http://www.clinicaltrials.gov）。
