Comparison of the results of laparoscopic appendectomies with application of different techniques for closure of the appendicular stump

Abstract

Background: Nowadays laparoscopy is used frequently not only in elective surgery but also in abdominal emergencies, including acute appendicitis. There are several techniques used to close the appendicular stump during laparoscopic appendectomy. The aim of the study was to present and compare the results of minimally invasive appendectomies performed with the use of endoscopic staplers (group A), titanium endoclips (group B) and invaginating sutures (group C). Methods: Three hundred seven patients (mean age=35.6; SD=15.9; 178 males,129 females) operated on laparoscopically for acute appendicitis from January 2010 to December 2014 at our department were included in the study. We reviewed retrospectively patients' data including: age, sex, duration of the surgical procedure and hospital stay, mortality, intraoperative and postoperative complication rates in all analyzed groups. Results: There were 102 patients in group A (mean age=35.8;SD=15.4; 57 males, 45 females). The average hospital stay in this group was 4.3 days (SD=1.7), average operation time was 62.0 min (SD=15), postoperative complication rate was 5.9 %. There were 160 patients in group B (mean age=35.0; SD=16.3; 96 males, 64 females). The average hospital stay in this group was 3.6 days (SD=1.4), average operation time was 62.9 min (SD=13.5), postoperative complication rate was 5.6 %. There were 45 patients in group C (mean age =37.3; SD=15.8; 25 males, 20 females). The average hospital stay in this group was 4.6 days (SD=2.0), average operation time was 73.9 min (SD=20.8), postoperative complication rate was 6.7 %. There were no intraoperative complications and no mortality in all compared groups of patients operated on laparoscopically for acute appendicitis. Conclusions: Laparoscopic appendectomies with application of different techniques for closure of the appendicular stump are useful and safe. In our study the shortest hospital stay and lowest complication rate were observed in patients operated with the use of titanium endoclips. The longest hospital stay and operation time and the highest complication rate was associated with the use of invaginating sutures.