Department of General Surgery, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Türkiye.
J Laparoendosc Adv Surg Tech A. 2024 Sep;34(9):822-828. doi: 10.1089/lap.2024.0132. Epub 2024 May 21.
Today, laparoscopy is frequently used in abdominal emergencies such as acute appendicitis. There are several techniques used to close the appendiceal stump during laparoscopic appendectomy. We aimed to compare the use of handmade loop and Hem-o-lok used to close the appendiceal stump in public hospitals where resources are limited, in terms of surgical outcomes and cost. Between January 2020 and December 2022, patients for whom handmade loops and Hem-o-loks were used to close the appendiceal stump during laparoscopic appendectomy in our clinic were included in the study. There were a total of 638 patients (mean age: 33 ± 13.5 years, 325 females and 313 males) in the patient cohort. Demographic and clinical data, duration of surgery, complications, hospital stay, pathology reports, mortality, and cost of supplies were compared between the two groups. There were 308 patients in the handmade loop group (160 females, 148 males, mean age: 33.7 years, range: 18-85 years) and 330 patients in the Hem-o-lok group (166 females, 164 males, mean age: 32.5 years, range: 18-89 years). There was no significant difference between the two groups for American Society of Anesthesiologists score, duration of symptom, hospital stay, intensive care unit stay, preoperative laboratory values, histopathological results, mortality, and morbidity ( > .05). The mean operation time was 48.76 ± 16.16 minutes in the handmade loop group and 40.53 ± 11.63 minutes in the Hem-o-lok group ( = 0.001). In terms of cost, the cost per case of Hem-o-lok group was about 25.8 times as much as the group that used sutures ($31 versus $1.2). Both methods can be used safely in laparoscopic appendectomy. The use of Hem-o-lok has no advantage other than shortening the operation time. However, it is costlier. Especially in peripheral hospitals where resources are limited, closing the appendiceal stump using a handmade loop is an easy, safe, and cost-effective method.
目前，腹腔镜技术常用于治疗急性阑尾炎等腹部急症。在腹腔镜阑尾切除术中，有几种方法可用于闭合阑尾残端。本研究旨在比较在资源有限的公立医院中，使用手工套扎环和 Hem-o-lok 闭合阑尾残端的手术效果和成本。
2020 年 1 月至 2022 年 12 月，在我院接受腹腔镜阑尾切除术时使用手工套扎环和 Hem-o-lok 闭合阑尾残端的患者纳入本研究。共有 638 例患者（平均年龄：33 ± 13.5 岁，女性 325 例，男性 313 例）。比较两组患者的一般资料、手术时间、并发症、住院时间、病理报告、死亡率和耗材费用。
手工套扎环组 308 例（女性 160 例，男性 148 例，平均年龄 33.7 岁，范围 18-85 岁），Hem-o-lok 组 330 例（女性 166 例，男性 164 例，平均年龄 32.5 岁，范围 18-89 岁）。两组患者的美国麻醉医师协会评分、症状持续时间、住院时间、重症监护病房停留时间、术前实验室值、组织病理学结果、死亡率和发病率差异均无统计学意义（＞0.05）。手工套扎环组的平均手术时间为 48.76 ± 16.16 分钟，Hem-o-lok 组为 40.53 ± 11.63 分钟（ = 0.001）。就成本而言，Hem-o-lok 组的每个病例费用约为缝线组的 25.8 倍（$31 比 $1.2）。
两种方法均可安全用于腹腔镜阑尾切除术。Hem-o-lok 的使用除了缩短手术时间外，没有其他优势。然而，它的成本更高。特别是在资源有限的基层医院，使用手工套扎环闭合阑尾残端是一种简单、安全且具有成本效益的方法。
