Appendiceal stump closure with polymeric clips is a reliable alternative to endostaplers
- Resource Type
- Authors
- Peter Mazel; Raphael N. Vuille-dit-Bille; Stefan Breitenstein; Ralph F. Staerkle; Christopher Soll
- Source
- The Journal of International Medical Research
Journal of International Medical Research, Vol 48 (2020)
- Subject
- Novel technique
Adult
Male
medicine.medical_specialty
Medicine (General)
appendicitis
Polymers
education
Closure (topology)
030204 cardiovascular system & hematology
Biochemistry
Special Issue: Surgical Innovation: New Surgical Devices, Techniques and Progress in Surgical Training
03 medical and health sciences
Young Adult
0302 clinical medicine
R5-920
Surgical Stapling
medicine
Humans
clip
cardiovascular diseases
CLIPS
Abscess
computer.programming_language
Retrospective Studies
business.industry
Biochemistry (medical)
Cell Biology
General Medicine
Middle Aged
endostapler
medicine.disease
Prognosis
Surgical Instruments
appendectomy
Appendicitis
nervous system diseases
Surgery
appendiceal stump
surgical procedures, operative
030220 oncology & carcinogenesis
Appendiceal stump
cardiovascular system
Female
Laparoscopy
business
computer
- Language
- ISSN
- 1473-2300
Objective Polymeric (Hem-o-lok) clips represent a novel technique with which to ligate the appendiceal stump following laparoscopic appendectomy. We compared the outcomes of using polymeric clips versus endostaplers for complicated and uncomplicated appendicitis. Methods Six hundred seventy-three consecutive patients undergoing laparoscopic appendectomy with polymeric clips or endostaplers for acute appendicitis were assessed. The primary outcome was the incidence of intra-abdominal abscesses. Predictors of postoperative intra-abdominal abscesses were calculated using univariate and multivariate analyses. Results Polymeric clips were used in 65% of patients and endostaplers were used in 35%. Hem-o-lok clips were not only applied in patients with uncomplicated appendicitis (83%), but also in those with complicated appendicitis (26%). The frequency of intra-abdominal abscesses using polymeric clips and endostaplers was similar in both patients with uncomplicated appendicitis (1% vs. 3%, respectively) and complicated appendicitis (2% vs. 6%, respectively). The univariate and multivariate analyses showed that the stump closure technique was not a risk factor for postoperative abscesses. Conclusions Closure of the appendiceal stump using the nonabsorbable Hem-o-lok ligation system in patients with both uncomplicated and complicated appendicitis is a safe alternative to the application of endostaplers.