Faculty of Medicine, Elmergib University, Al-Khums, Libya.
Medical Research Group of Libya, Negida Academy, Arlington, MA, USA.
Langenbecks Arch Surg. 2024 Sep 5;409(1):270. doi: 10.1007/s00423-024-03452-3.
Choosing the best stump closure method for laparoscopic appendectomy has been a debated issue, especially for patients with acute appendicitis. The lack of consensus in the literature and the diverse techniques available have prompted the need for a comprehensive evaluation to guide surgeons in selecting the most optimal appendiceal stump closure method.
A comprehensive search was conducted on multiple databases from inception until December 2023 to find relevant studies according to eligibility criteria. The primary outcome was the incidence of total complications.
25 studies with a total of 3308 patients were included in this study, overall complications did not reveal a significant advantage for any intervention (RR = 0.72, 95% CI: 0.53; 1.01), Superficial and deep infection risks were similar across all methods, Operative time was significantly longer with endoloop and Intracorporeal sutures (MD = 7.07, 95% CI: 3.28; 10.85) (MD = 26.1, 95% CI: 20.9; 31.29).
There are no significant differences in overall complications among closure methods. However, Intracorporeal sutures and endoloop techniques were associated with extended operative durations.
选择最佳的腹腔镜阑尾切除术残端闭合方法一直是一个有争议的问题，特别是对于急性阑尾炎患者。文献中缺乏共识，并且有多种技术可供选择，这促使我们需要进行全面评估，以指导外科医生选择最合适的阑尾残端闭合方法。
根据纳入标准，从创建到 2023 年 12 月，我们在多个数据库中进行了全面检索，以查找相关研究。主要结局是总并发症的发生率。
本研究共纳入 25 项研究，共计 3308 例患者。总体并发症并没有显示任何干预措施有显著优势（RR=0.72，95%CI：0.53；1.01）。所有方法的浅表和深部感染风险相似，而使用 Endoloop 和体内缝合的手术时间明显更长（MD=7.07，95%CI：3.28；10.85）（MD=26.1，95%CI：20.9；31.29）。
各种闭合方法之间的总并发症没有显著差异。然而，体内缝合和 Endoloop 技术与手术时间延长有关。
