Use of Endo-GIA Versus Endo-loop for Securing the Appendicular Stump in Laparoscopic Appendicectomy

Sajid, M. S.; Rimple, Jasmin; Cheek, Elizabeth; Baig, Mirza

doi:10.1097/sle.0b013e31818a66ab

Cited by 80 publications

(66 citation statements)

References 16 publications

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“…One retrospective cohort study reported a significantly higher SSI rate and hospital readmission rate among adults with acute appendicitis managed by EL compared with ES and concluded that ES provided more secure stump closure than EL, 19 whereas a recent metaanalysis reported no difference in complication rates between patients managed with EL versus ES. 20 One prospective trial of 1 versus 2 proximal ELs in LA found no outcome difference between groups and concluded that a minimally inflamed appendiceal base could be safely controlled by a single EL. 21 …”

Section: Discussionmentioning

confidence: 99%

Endoloop versus endostapler closure of the appendiceal stump in pediatric laparoscopic appendectomy

2012

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Background: There is little information available to inform choice of technique for appendiceal stump control in pediatric laparoscopic appendectomy (LA). We compared complications (stump leak, intra-abdominal abscess formation [IAA], surgical site infection [SSI]) in children undergoing LA for perforated (PA) and nonperforated appendicitis (NPA) by technique of appendiceal stump control.Methods: All children who underwent LA for confirmed acute appendicitis between 2006 and 2009 were reviewed. Choice of stump control (endoloop [EL] or endostapler [ES]) was determined by surgeon preference. Interactions between stump closure techniques and other potential confounders (intra-abdominal drain, irrigation, different antibiotic regimens) were explored using a logistic regression model. Results:Of 242 patients undergoing LA, 57 (23.6%) had PA. In the PA group the appendiceal stump was closed with EL in 47 (82.5%) patients, while in the NPA group EL was used in 161 (87%) patients. Among PA patients, IAA was more common in the ES than the EL group (5 of 10 [50%] v. 6 of 47 [12.7%]). There was no significant difference in rates of SSI. Among NPA patients, there were no differences in rates of IAA or SSI. There were no stump leaks in either group. Logistic regression analysis confirmed the predictive effect of ES use on IAA formation in PA (adjusted odds ratio 7.09; 95% confidence interval 1.08-46.13; p = 0.042). Conclusion:Our data suggest that in most cases of PA, the appendiceal stump can be safely controlled with EL. Within the PA group, the higher rates of IAA seen in ES patients may be attributable to the quality of the appendiceal stump rather than the technique of closure. Résultats : Sur 242 patients qui ont subi une AL, 57 (23,6 %) avaient une AP. Chez les patients qui avaient une AP, le moignon de l'appendicite a été refermé par ligature EL dans 47 cas (82,5 %), tandis qu'on a utilisé la ligature EL chez 161 (87 %) des patients qui avaient une ANP. Chez les patients qui avaient une AP, l'ICO était plus fréquente chez ceux qui ont reçu des agrafes ES que chez ceux qui ont reçu une ligature EL (5 sur 10 [50 %] c. 6 sur 47 [12,7 %]). Il n'y avait pas de différence significative sur le plan des taux d'ICO. Chez les patients qui avaient une ANP, on n'a constaté aucune différence quant au taux d'apparition d'un AIA ou d'une ICO. Il n'y avait pas de fuite au niveau du moignon chez les membres des 2 groupes. L'analyse par régres-sion logistique a confirmé l'effet prédicteur de l'utilisation de l'agrafe ES sur l'apparition d'AIA dans les cas d'AP (ratio d'incidence ajusté 7,09; intervalle de confiance à 95 %, 1,08-46,13; p = 0,042).

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Section: Discussionmentioning

confidence: 99%

Endoloop versus endostapler closure of the appendiceal stump in pediatric laparoscopic appendectomy

2012

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“…But every technique has its own benefits and handicaps. [5,[17][18][19][20][21] For example use of endo-loop for CAS in some cases may prolong the surgery time due to the need for an experience for the application and alignment of the loop. [22] The titanium clips that may be used also has a risk of displacement during the manipulations in the laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

The Safety And Efficacy Of Different Methods Used For The Closure Of The Appendiceal Stump (CAS) İn Laparoscopic Appendectomy

Tolan¹

2017

Laparosc Endosc Surg Sci

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“…Güvenli, ulaşilabilir, teknik olarak kolay ve maliyeti uygun optimal kapatma yöntemi henüz tanimlanmamiştir. Güdük kapatma esnasinda kullanilan materyallerin çoğu yüksek maliyeti ve ameliyat süresini uzatmasi nedeniyle laparoskopinin popülaritesini azaltmaktadir [7,8].…”

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A safe and cheap method for closing the appendiceal stump in laparoscopic appendectomy: Hand made loop

Özsoy¹,

Okan²,

Özmen³

2017

Pau Med J

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ÖzetAmaç: Bu çalişma ile apendiks güdüğünün kapatilmasinda modifiye bir teknik olarak el yapimi loop kullaniminin ameliyat sonuçlari üzerinde etkisini araştirmayi hedefledik. AbstractPurpose: Our aim in this study is to describe the handmade loop as a modified technique for closing the appendiceal stump and discuss its effects on outcome. Meterials and Methods:Patients who underwent laparoscopic appendectomy due to acute appendicitis between January 2012 and January 2015 and in whom the handmade loop technique was used were included in the study.The demographic and clinical findings, surgical complications and length of stay in hospital were all retrieved from patients files. Results were discussed with relevant literature. Results:A total of 197 patients were enrolled in the study. 111 male (56.3%) and 86 female (43.6%) patients were operated. Median age of the patients was 30.9 ± 12.9. The mean operative time was 52.5 ± 20.4 minutes. In 14 patients (7.1%) a complicated appendicitis (perforation/ abscess) was observed. Mean duration of hospital stay was 2.49 ± 1.25 days. !8 patients (9.1%) experienced post op complications. These were trocar site infection in 12 patients, postoperative ileus in the early postoperative period in 4 patients, and one pelvic abscess (treated with percutaneous drainage). None required re operation. Conclusion:The handmade loop is a safe method to close the appendix stump in laparoscopic appendectomy. Using this method can reduce the cost of laparoscopic appendectomy.Pam Med J 2017;(2):130-134

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Use of Endo-GIA Versus Endo-loop for Securing the Appendicular Stump in Laparoscopic Appendicectomy

Cited by 80 publications

References 16 publications

Endoloop versus endostapler closure of the appendiceal stump in pediatric laparoscopic appendectomy

Endoloop versus endostapler closure of the appendiceal stump in pediatric laparoscopic appendectomy

The Safety And Efficacy Of Different Methods Used For The Closure Of The Appendiceal Stump (CAS) İn Laparoscopic Appendectomy

A safe and cheap method for closing the appendiceal stump in laparoscopic appendectomy: Hand made loop

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