Department of General Surgery, Istanbul University- Cerrahpasa Cerrahpasa Medical Faculty, İstanbul-Türkiye.
Department of Radiology Istanbul University- Cerrahpasa Cerrahpasa Medical Faculty, İstanbul-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2024 Nov;30(11):795-801. doi: 10.14744/tjtes.2024.76353.
Acute appendicitis is a common surgical emergency that causes acute abdominal pain and affects approximately 7-8% of the population during their lifetime. The closure of the appendix stump during laparoscopic appendectomy is one of the most critical steps of the surgery to prevent life-threatening complications such as postoperative fistula, peritonitis, and sepsis. The mate-rial chosen for appendix stump closure must be effective, safe, and economical. However, there is still no consensus on the optimal method for stump closure. In this study, we aimed to compare the advantages and reliability of three different methods used for appendix stump closure.
At Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Department of General Surgery, cases that underwent laparoscopic appendectomy for acute appendicitis between January 2022 and April 2024 were retrospectively analyzed using the hospital's data system. The patients' demographic data, laboratory values, pathology reports, surgical notes, duration of hospital stay, duration of surgery, total hospital costs, complications related to the surgery within 30 days postoperatively, and the management of these complications were examined.
The study included a total of 150 individuals, with 83 (55.33%) males and 67 (44.67%) females. The average age of the participants was 38.45±14.48 years. In terms of the materials used for stump closure, endoloop was used in 82 (54.67%) cases, Hem-o-lok clip in 30 (20.00%) cases, and endostapler in 38 (25.33%) cases. In 144 (96%) cases, no Clavien-Dindo (CD) complications were observed, while complications occurred in six (4%) cases. These six complications included two intra-abdominal abscesses (CD Grade 3), two wound infections (CD Grade 1), one case of bleeding (CD Grade 2), and one pulmonary embolism (CD Grade 4).
The use of endoloop, polymeric clips, and endostapler in laparoscopic appendectomy is safe and effective for appendectomy. All three methods can be successfully applied without an increase in intraoperative or postoperative complications. However, due to the higher treatment costs associated with endostapler, its use should be reserved for situations where securing the appendix stump cannot be achieved with endoloop or Hem-o-lok clip.
急性阑尾炎是一种常见的外科急症，可引起急性腹痛，影响约 7-8%的人群在其一生中。腹腔镜阑尾切除术时阑尾残端的闭合是手术中最关键的步骤之一，可预防术后瘘、腹膜炎和败血症等危及生命的并发症。选择用于阑尾残端闭合的材料必须有效、安全且经济实惠。然而，对于残端闭合的最佳方法仍然没有共识。在这项研究中，我们旨在比较三种不同方法用于阑尾残端闭合的优缺点和可靠性。
在伊斯坦布尔大学 - 切拉帕萨的切拉帕萨医学院普通外科系，使用医院的数据系统回顾性分析了 2022 年 1 月至 2024 年 4 月期间因急性阑尾炎行腹腔镜阑尾切除术的病例。检查了患者的人口统计学数据、实验室值、病理报告、手术记录、住院时间、手术时间、总住院费用、术后 30 天内与手术相关的并发症以及这些并发症的处理。
该研究共纳入 150 名患者，其中男性 83 例（55.33%），女性 67 例（44.67%）。参与者的平均年龄为 38.45±14.48 岁。在残端闭合材料方面，使用 Endoloop 的有 82 例（54.67%），使用 Hem-o-lok 夹的有 30 例（20.00%），使用 Endostapler 的有 38 例（25.33%）。在 144 例（96%）患者中，未观察到 Clavien-Dindo（CD）并发症，而 6 例（4%）发生了并发症。这 6 例并发症包括 2 例腹腔脓肿（CD 3 级）、2 例伤口感染（CD 1 级）、1 例出血（CD 2 级）和 1 例肺栓塞（CD 4 级）。
在腹腔镜阑尾切除术中使用 Endoloop、聚合夹和 Endostapler 进行阑尾切除术是安全有效的。这三种方法都可以成功应用，不会增加术中或术后并发症。然而，由于 Endostapler 的治疗费用较高，应保留用于无法使用 Endoloop 或 Hem-o-lok 夹来固定阑尾残端的情况。
