Optimal stump management in laparoscopic appendectomy: A network meta-analysis by the Minimally Invasive Surgery Synthesis of Interventions and Outcomes Network

Antoniou, Stavros A.; Mavridis, Dimitris; Hajibandeh, Shahab; Hajibandeh, Shahin; Antoniou, George Α.; Gorter, Ramon R.; Tenhagen, Mark; Koutras, Christos; Pointner, Rudolph; Chalkiadakis, George; Granderath, Frank A.; Fragiadakis, George; Philalithis, Αnastas; Bonjer, H. Jaap

doi:10.1016/j.surg.2017.07.013

Cited by 28 publications

(32 citation statements)

References 65 publications

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“…Recently, 43 randomized controlled trials enrolling over 5,000 patients were analyzed in the network meta-analysis by Antoniou et al The authors concluded that the use of suture ligation of the appendix in LA seems to be superior to other methods for the composite parameters of organ/ space and superficial operative site infection [171].…”

Section: Q47: Does Aspiration Alone Confer Clinical Advantages Overmentioning

confidence: 99%

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

et al. 2020

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Background and aims: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of nonoperative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and perioperative antibiotic therapy.

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Section: Q47: Does Aspiration Alone Confer Clinical Advantages Overmentioning

confidence: 99%

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

et al. 2020

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“…et al (2015) suggested the use of a single stapler line to dissect the mesoappendix and apply to the appendix as a safe and effective method that leads to a shorter duration of surgery and excellent surgical results [31]. A meta-analysis by Antoniou S.A. et al (2017) involving more than 5000 patients showed that the use of suture material, that is, appendix ligation is superior to other methods given the combined parameters of infection of the organ and the surface of the operating field [8]. In another study, Qian D. et al (2015) compared simple ligation and stump invagination, and no significant difference was found, and as a consequence, clinical results showed that simple ligation was significantly superior to stump invagination [24].…”

Section: Resultsmentioning

confidence: 99%

Surgical Treatment of Primary Intra-Abdominal Complications: Abscesses and Infiltrates

Skyba

Rybalchenko

Ivanko

et al. 2021

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Purpose of the work. improving the results of surgical treatment of patients with primary intra-abdominal infiltrates and abscesses. Material and methods. From 2006 to 2019, 191 patients with primary intra-abdominal infiltrates and abscesses were treated. The patients' age ranged from 16 to 85 years. There were 96 male patients (50.26%), 95 female patients (49.74%). Results. The patients were divided into 3 subgroups depending on the underlying disease. The first group included 74 (38.74%) patients with destructive appendicitis, of which 39 (20.42%) were in the control group, and 35 (18.32%) were studied. The second group included 48 (25.13%) patients suffering from perforated gastric ulcer and 12 duodenal ulcer, of which the control group was 26 (13.61%), and the studied group was 22 (11.52%). The third group included 69 (36.13%) patients with cholecystitis, of which 37 (19.37%) were in the control group, and 32 (16.76%) were studied. All patients were operated on. Conclusions. Surgical treatment is individualized depending on the disease, so with destructive appendicitis from 74 (38.74%) laparotomic in 42 (21.99%), laparoscopic in 32 (16.75%), and in 12 (6.28%) with conversion; perforated gastric ulcer and 12 duodenal ulcer in 48 (25.13%) open laparotomy; with cholecystitis from 69 (36.13%) in 48 (25.13%) laparotomic and in 21 (11.00%) laparoscopically. The use of water-jet technologies in 64 (33.51%) patients made it possible to minimize damage to the serous membrane and cleanse the peritoneum from acquired formations.

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“…In a recent meta-analysis, Antoniou et al revealed that laparoscopic appendectomy had a 5.5-fold probability of offering a better treatment strategy compared with conventional appendectomy. 9 The reduced number of wound infections in the LA group results from the lack of contamination of the body tissues, mainly subcutaneous tissue via appendiceal transection, fluid in the peritoneum, and surgeon's manipulations. In addition, the smaller length of the wound and its separation from the source of the illness via removal of the specimen through an incision below the umbilicus also contribute to the reduction in wounds.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Open and Laparoscopic Appendectomy With Single Endoloop Stump Closure

Mitura

Wyrzykowsk

2018

JSLS

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Background and Objectives:Although laparoscopic appendectomy (LA) has been used for 35 years, the open approach (OA) is preferred worldwide. Widespread access to instrumentation in a number of centers has reduced economic and logistical obstacles. The aim of this work is to compare the results for patients with suspected appendicitis treated using an OA versus patients treated using LA.Methods:A retrospective study of all patients (N = 290) who underwent operation due to suspected appendicitis in the General Surgery Department from 2014 to 2017 was conducted. LA was performed in 91 patients, and OA was performed in 199 patients.Results:Average surgery duration was 67.8 minutes in the LA group and 62.9 minutes in the OA group (P =.082). It was necessary to perform 3 conversions (3.3%) from LA to OA. Wound infections occurred in 2.2% of patients in the LA group and in 12.6% of patients in the OA group (P = .007). A reduced duration of hospitalization was noted in the LA group (3.3 days) compared with the OA group (4.7 days) (P < .001).Conclusion:The duration of LA is not considerably longer than that of OA. LA in patients with suspected appendicitis reduces the number of operation site infections compared with OA. LA with single endoloop stump closure is a safe method and may be recommended for wider applications.

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Optimal stump management in laparoscopic appendectomy: A network meta-analysis by the Minimally Invasive Surgery Synthesis of Interventions and Outcomes Network

Cited by 28 publications

References 65 publications

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Surgical Treatment of Primary Intra-Abdominal Complications: Abscesses and Infiltrates

Outcomes of Open and Laparoscopic Appendectomy With Single Endoloop Stump Closure

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