Self-Locking Polymeric Clips Are Safe for the Closure of Appendiceal Stump in Laparoscopic Appendectomy
Abstract
:1. Introduction
2. Methods
2.1. Study Population
2.2. Data Collection
2.3. Hypothesis and Outcomes Measures
2.4. Operative Technique
2.5. Statistical Analysis
3. Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Inclusion Criteria | Exclusion Criteria |
---|---|
Adults ≥ 18 years of age | Patients treated conservatively |
Patients with acute appendicitis diagnosis | Patients underwent open appendectomy |
Patients underwent laparoscopic appendectomy | Patients who needed a stapler application |
Closure Method of the Appendix Stump | |||||
---|---|---|---|---|---|
Variable | N | Overall, N = 515 1 | Clip, N = 454 1 | Loop, N = 61 1 | p-Value 2 |
Sex | 515 | >0.99 | |||
Female | 245 (48%) | 216 (48%) | 29 (48%) | ||
Male | 270 (52%) | 238 (52%) | 32 (52%) | ||
Age | 515 | 37 (15) | 36 (15) | 40 (17) | 0.16 |
Histological findings | 515 | 0.27 | |||
Early changes | 15 (2.9%) | 14 (3.1%) | 1 (1.6%) | ||
Secondary changes | 6 (1.2%) | 5 (1.1%) | 1 (1.6%) | ||
Phlegmonous appendicitis | 338 (66%) | 304 (67%) | 34 (56%) | ||
Gangrenous appendicitis | 105 (20%) | 89 (20%) | 16 (26%) | ||
Perforated appendicitis | 51 (9.9%) | 42 (9.3%) | 9 (15%) |
Closure Method of the Appendix Stump | |||||
---|---|---|---|---|---|
Variable | N | Overall, N = 515 1 | Clip, N = 454 1 | Loop, N = 61 1 | p-Value 2 |
Complications | 515 | >0.99 | |||
Complications: No | 506 (98%) | 446 (98%) | 60 (98%) | ||
Complications: Yes | 9 (1.7%) | 8 (1.8%) | 1 (1.6%) | ||
Length of stay | 515 | 3.15 (1.81) | 3.09 (1.72) | 3.61 (2.36) | 0.18 |
Clips Group, N = 454 | Loops Group, N = 61 | ||||
---|---|---|---|---|---|
Complication | C–D Grade | Histological Diagnosis | Complication | C–D Grade | Histological Diagnosis |
Wound infection | 1 | Phlegmonous appendicitis | Postoperative fever | 1 | Perforated appendicitis |
Hemoperitoneum, anemia | 3b | Early changes | |||
Intra-abdominal abscess | 2 | Secondary changes | |||
Intra-abdominal abscess | 2 | Perforated appendicitis | |||
Abdominal wall ligature fistulae | 1 | Phlegmonous appendicitis | |||
Intra-abdominal abscess | 2 | Gangrenous appendicitis | |||
Typhlitis | 2 | Perforated appendicitis | |||
Postoperative fever | 1 | Perforated appendicitis |
Closure Methods of the Appendix Stump | Cost (€)/Unit | Cost (€)/Surgery | Cost (€)/515 Patients |
---|---|---|---|
Self-locking polymeric clip | 7.69 | 7.69 | 3960.35 |
Vicryl loop | 30.45 | 91.35 | 47,045.25 |
PDS loop | 32.17 | 96.51 | 49,702.65 |
Echelon stapler (FlexTM 45) | 514.50 | 514.50 | 264,967.50 |
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Marcinkeviciute, K.; Luksaite-Lukste, R.; Jasiunas, E.; Poskus, T. Self-Locking Polymeric Clips Are Safe for the Closure of Appendiceal Stump in Laparoscopic Appendectomy. Medicina 2023, 59, 533. https://doi.org/10.3390/medicina59030533
Marcinkeviciute K, Luksaite-Lukste R, Jasiunas E, Poskus T. Self-Locking Polymeric Clips Are Safe for the Closure of Appendiceal Stump in Laparoscopic Appendectomy. Medicina. 2023; 59(3):533. https://doi.org/10.3390/medicina59030533
Chicago/Turabian StyleMarcinkeviciute, Kristina, Raminta Luksaite-Lukste, Eugenijus Jasiunas, and Tomas Poskus. 2023. "Self-Locking Polymeric Clips Are Safe for the Closure of Appendiceal Stump in Laparoscopic Appendectomy" Medicina 59, no. 3: 533. https://doi.org/10.3390/medicina59030533