Technik und Bedeutung der Stumpfversorgung für das Ergebnis der laparoskopischen Appendektomie

Klima, Stefan; Schyra, B

doi:10.1007/978-3-642-80295-9_146

Cited by 1 publication

(3 citation statements)

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“…The patients from this study were not included in the final analysis. Four studies compared LA using staplers and LA using loops [12,14,17,25]. Three of these studies had a three-armed design randomizing patients to laparoscopic appendectomy with loops, staplers, or a third procedure.…”

Section: Resultsmentioning

confidence: 99%

“…Three of these studies had a three-armed design randomizing patients to laparoscopic appendectomy with loops, staplers, or a third procedure. The third procedure was open appendectomy [17], extracorporeal stump ligation [25], or additional sinking of the appendix stump [12]. One trial was performed with children [25].…”

Section: Resultsmentioning

confidence: 99%

“…Placement of two loops on the appendiceal stump to provide more secure closure of the appendiceal stump has been suggested, although this will not avoid transsection per se [6]. Oversewing of the appendiceal stump possibly prevents complications, but requires considerable expertise in laparoscopic suturing techniques [12]. The observation that the numbers of intraabdominal abscesses were comparable in the two groups and that the hospital stays did not differ can possibly be attributed to the sample size in this study, although all currently available data from the literature were pooled.…”

Section: Discussionmentioning

confidence: 99%

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Securing the appendiceal stump in laparoscopic appendectomy: evidence for routine stapling?

et al. 2006

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Background: This metaanalysis aimed to compare endoscopic linear stapling and loop ligatures used to secure the base of the appendix. Methods: Randomized controlled trials on appendix stump closure during laparoscopic appendectomy were systematically searched and critically appraised. The results in terms of complication rates, operating time, and hospital stay were pooled by standard metaanalytic techniques. Results: Data on 427 patients from four studies were included. The operative time was 9 min longer when loops were used (p = 0.04). Superficial wound infections (odds ratio [OR], 0.21; 95% confidence interval (CI), 0.06-0.71; p = 0.01) and postoperative ileus (OR, 0.36; 95% CI, 0.14-0.89; p = 0.03) were significantly less frequent when the appendix stump was secured with staples instead of loops. Of 10 intraoperative ruptures of the appendix, 7 occurred in loop-treated patients (p = 0.46). Hospital stay and frequency of postoperative intraabdominal abscess also were comparable in loop-treated and staple-treated patients. Conclusions: The clinical evidence on stump closure methods in laparoscopic appendectomy favors the routine use of endoscopic staplers.

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Section: Resultsmentioning

confidence: 99%