Evidence-based surgery for laparoscopic appendectomy: A stepwise systematic review

Bessoff, Kovi; Choi, Jeff; Wolff, Christopher; Kashikar, Aditi; Carlos, Garrison; Caddell, Luke; Khan, Rida I.; Stave, Christopher D; Spain, David A.; Forrester, Joseph D.

doi:10.1016/j.sopen.2021.08.001

Cited by 11 publications

(14 citation statements)

References 54 publications

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“…[23] However, a recently published evidence-based review recommends the use of SRBs to prevent SSI on the basis of the retrospective study. [24] Similarly, in a retrospective study conducted in the USA reviewing a very large series, the use of SRBs has been shown to reduce the infection rate by 40%. [11] Nevertheless, in all such studies, why SRB has been used in some patients and why it was not used in others is unknown due to the retrospective nature of these studies.…”

Section: Discussionmentioning

confidence: 97%

Is it necessary to use specimen retrieval bag for reducing surgical site infection in laparoscopic appendectomy?: A randomized controlled trial

Bostan

Ugurlu

2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:The aim of the study was to investigate the comparison the effects of the extraction of specimen by using a specimen retrieval bag (SRB) or direct extraction through trochar in terms of surgical site infection (SSI) in patients who underwent laparoscopic appendectomy. METHODS:A total of 165 patients were randomly allocated into two groups. A SRB was used in 77 patients (Group 1, 46.7%) and not used in 88 patients (Group 2, 53.3%). Demographics, comorbid diseases, laboratory results, preoperative diameter of appendix, intraoperative observations, intraoperative procedures, hospitalization times, SSIs, pathology results, culture results, and findings of the patients who developed complications and the treatments given to the patients due to complications during the post-operative period were recorded. RESULTS:The mean age of the patients was 33.95 SD 13.25 (min-max: 18-78) years. No significant difference was observed in the demographics, hospitalization times, distribution of the incidence rates of diabetes mellitus, perioperative perforation, perioperative fluid/abscess, drain insertion, aspiration-irrigation, superficial incisional SSI, drainage requirement, leakage, positive culture results, and post-operative intra-abdominal infection (p>0.05) between the groups. Neutrophil and leukocyte values were statistically significantly different between the groups (p=0.044 and p=0.012, respectively). There was a significant difference between the two groups in terms of the complicated appendicitis (p=0.040). There was no significant difference in terms of the positive culture results and incidence of post-operative intra-abdominal infection between the patients in Group 1 and Group 2 in both the complicated and uncomplicated appendicitis groups (p>0.05). The difference between the patients in Group 1 and Group 2 regarding the incidence of superficial incisional SSI was significant in the uncomplicated appendicitis group (p=0.037), whereas not significant in the complicated appendicitis group (p=1.000). In the multivariate model, only perioperative perforation was observed to be the effective parameter on post-operative intra-abdominal infection at the p<0.05 level (p=0.045). CONCLUSION:The results of the present study revealed that the use of SRB does not prevent microbial seeding in patients who underwent laparoscopic appendectomy; therefore, it was concluded that using SRB is not associated with SSI at laparoscopic appendectomy.

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Section: Discussionmentioning

confidence: 97%

Is it necessary to use specimen retrieval bag for reducing surgical site infection in laparoscopic appendectomy?: A randomized controlled trial

Bostan

Ugurlu

2023

Ulus Travma Acil Cerrahi Derg

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“…In the comparative studies of laparoscopic versus open appendectomy or laparoscopic versus single-port appendectomy, which are frequently performed in appendectomy, it was found that surgery times were within the range of 29 to 62 min, similar to the surgery times in our study. 11,16,17 There are many perioperative factors affecting the reported surgery times, which explains the result of the wide time interval. Among the perioperative factors, the trocar entry sites, which provide optimal operating comfort, are at the fore.…”

Section: Discussionmentioning

confidence: 99%

Trocar Site Location in Laparoscopic Appendectomy—A Prospective Randomized Study

Gundogan,

Carkit,

Cinar

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Introduction: Laparoscopic appendectomy has been used in the treatment of appendicitis, which is among the most common emergency pathologies worldwide. There is no consensus on the best trocar entry sites. The purpose of the present study was to compare various trocar entry sites in the literature and to find the localization with the optimal usage area. Methods: Patients who underwent laparoscopic appendectomy between 2021 and 2022 were randomized into 4 groups and included in the study. The demographic data, perioperative, and postoperative findings of the patients were evaluated. Results: A total of 200 patients participated in the study and 73% were male. No differences were detected between the groups in terms of demographic data, preoperative findings, length of stay, and complications of the patients. However, when the mean surgery times of the groups were examined (47.2±26.9, 58.4±23.1, 54.5±18.3, 55.8±18.6 min), it was observed that this period was less in Group 1 (P=0.02). When the postoperative Visual Analogue Scale values were analyzed (4.8±2.2, 6.2±1.7, 5.5±2.0, and 5.8±1.9), Group 1 was found to be less painful (P=0.00001). Conclusion: When the surgical procedure is optimized and environmental factors are homogenized, Group 1 trocar entry sites seem advantageous for the procedure in terms of postoperative patient pain scale and operation times.

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“…A common operative approach in open appendectomy, especially in pediatric patients, involves ligation and inversion of the appendiceal stump into the cecum. The proposed advantages of stump inversion include double closure of the cecal wall, decreased contamination from an intra-peritoneal stump, and minimized risk of adhesions [3]. However, there are reports of an appendiceal stump harboring a neoplasm [4][5].…”

Section: Introductionmentioning

confidence: 99%

Appendiceal Inversion Presenting as a Cecal Polypoid Mass on Screening Colonoscopy: A Case Report and Review of Available Diagnostic Adjuncts to Differentiate Benign From Malignant Colorectal Pathology

Axentiev¹,

Shehzad²,

Bernescu³

2023

Cureus

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Appendiceal inversion is uncommon. It may be a benign finding or seen in association with malignant pathology. When detected, it masquerades as a cecal polyp which poses a diagnostic dilemma with malignancy in the differential. In this report, we highlight a case of a 51-year-old patient with an extensive surgical history as a newborn in the setting of omphalocele and intestinal malrotation, who was found to have a 4 cm cecal polypoid growth on screening colonoscopy. He underwent a cecectomy for tissue diagnosis. Ultimately, the polyp was found to be an inverted appendix without evidence of malignancy. Currently, suspicious colorectal lesions which cannot be removed by polypectomy are primarily addressed with surgical excision. We reviewed the literature for available diagnostic adjuncts to better differentiate benign from malignant colorectal pathology. The application of advanced imaging and molecular technology will allow for improved diagnostic accuracy and subsequent operative planning.

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Evidence-based surgery for laparoscopic appendectomy: A stepwise systematic review

Cited by 11 publications

References 54 publications

Is it necessary to use specimen retrieval bag for reducing surgical site infection in laparoscopic appendectomy?: A randomized controlled trial

Is it necessary to use specimen retrieval bag for reducing surgical site infection in laparoscopic appendectomy?: A randomized controlled trial

Trocar Site Location in Laparoscopic Appendectomy—A Prospective Randomized Study

Appendiceal Inversion Presenting as a Cecal Polypoid Mass on Screening Colonoscopy: A Case Report and Review of Available Diagnostic Adjuncts to Differentiate Benign From Malignant Colorectal Pathology

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