Stump Invagination Versus Simple Ligation in Open Appendicectomy: A Systematic Review and Meta-Analysis

Qian, Daohai; He, Zhigang; Hua, Jie; Song, Zhijun

doi:10.9738/intsurg-d-15-00074.1

Cited by 6 publications

(6 citation statements)

References 15 publications

(14 reference statements)

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“…Eleven RCTs (2634 patients) were included in the systematic review and meta-analysis by Qian et al Postoperative pyrexia and infections were similar between simple ligation and stump inversion groups, respectively, but the former group had a shorter operative time, less incidence of postoperative ileus, and quicker postoperative recovery. The clinical results revealed that simple ligation was significantly superior to stump inversion [173].…”

Section: Q47: Does Aspiration Alone Confer Clinical Advantages Overmentioning

confidence: 97%

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: 97%

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

et al. 2020

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“…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]. Abdominal drainage is also debated.…”

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 meta-analysis comparing closure and burial of the AS in OA, the rates of postoperative fever and wound infection were found to be similar between OA, and LA. When compared as for operative time, postoperative ileus and recovery rate, and closure of the AS, LA was found to be a relatively superior technique (18) .…”

Section: Discussionmentioning

confidence: 96%

“…Some studies suggest that postoperative ileus and length of hospital stay may adversely affect out- comes. However, the scientific quality of these studies is not adequate to effectively stop surgeons from burying the AS (18,19) .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Stump Burying using Laparoscopic and Open Methods in Complicated Acute Appendicitis

Ferahman¹,

Dönmez²,

Yılmaz³

et al. 2020

BMJ

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Objective: The choice of laparoscopic technique in the treatment of complicated acute appendicitis (CAA) harbours debatable evidence because of higher rates of surgical complications such as postoperative intraabdominal abscess (POIIA). The aim of this study is to compare postoperative results of appendiceal stump (AS) ligation and its burial into the cecum using laparoscopic or open surgical techniques in patients with CAA. Method: This is a single-center and retrospective analysis of patients with CAA operated between May 2018 and April 2020. AS was intracorporeally knotted with silk and buried in the cecum with a purse-string suture (PSS). The patients were divided into open appendectomy (OA) and laparoscopic appendectomy (LA) groups. Data concerning demographic characteristics, intraoperative variables, hospital stay, surgical complications, morbidities, and postoperative findings were compared. Results: A total of 66 patients including 36 patients (54.54%) underwent LA and 30 patients had OA were enrolled in the study. Partial resection of cecum was performed in one patient in the OA group and two patients in the LA group with the help of a stapler due to cecal floor necrosis. The operative time and duration of hospital stay were significantly shorter in the LA group compared to the OA group. Surgical site infection and POIAA were significantlymore frequent in the OA group (p<0.001). Conclusion: In acute complicated appendicitis, laparoscopic method can be applied as an effective method by closing the appendiceal stump and burying into the cecum with a purse-string suture.

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Stump Invagination Versus Simple Ligation in Open Appendicectomy: A Systematic Review and Meta-Analysis

Cited by 6 publications

References 15 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

Comparison of Stump Burying using Laparoscopic and Open Methods in Complicated Acute Appendicitis

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