All Appendectomies Performed During the Designated Period in Single Medical Center
Conditions
Keywords
laparoscopic appendectomy, appendiceal stump, endoloop
Brief summary
comparing the rate and severity of postoperative complication after LA in regards of different appendiceal stump closure techniques. Data regarding different operative and postoperative parameters was collected from all appendectomies performed in a single medical center in Israel during the years 2010-2020.
Detailed description
To date, laparoscopic appendectomy (LA) is still the most common surgical procedure done in an acute setting \[1,2\]. Most patients presenting to the ER with acute appendicitis, will undergo an appendectomy in the same hospital admission \[3\]. The widely practiced technique for LA, is the placement of access trocars in a proper triangulation, insufflation of the abdomen to create a pneumoperitoneum, dissecting through the mesoappendix with electrothermal devices to expose the appendiceal base, appendiceal stump closure and appendiceal resection, and finally extraction of the resected appendix \[4\]. There are multiple techniques to close and secure the appendiceal stump. The use of staples, clips and prepared surgical knots such as the ENDOLOOP with PDS suture is widely in use. Although requiring less manual surgical skill to use, the costs of staples and clips are higher than the prepared suture, and the use of larger trocars is obligatory \[4\]. Yet, data comparing the postoperative efficacy and safety of these appendiceal stump closure techniques is scarce. The aim of this study is to compare the postoperative efficacy and safety of appendiceal stump closure techniques, and to assess their cost effectiveness. This is a retrospective, single center study, comparing the rate and severity of postoperative complication after LA. Data regarding different operative and postoperative parameters was collected from all appendectomies performed in a single medical center in Israel during the years 2010-2020.
Interventions
PROCEDURElaparoscopic appendectomy using a single endoloop for appendiceal stump closure
laparoscopic appendectomy using a single endoloop for appendiceal stump closure before resecting the appendix
PROCEDURElaparoscopic appendectomy using two endoloops for appendiceal stump closure
laparoscopic appendectomy using a two endoloops for appendiceal stump closure before resecting the appendix
PROCEDURElaparoscopic appendectomy using a clip for appendiceal stump closure
laparoscopic appendectomy using an endoclip for appendiceal stump closure before resecting the appendix
Sponsors
Meir Medical Center
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 120 Years
Healthy volunteers
No
Inclusion criteria
all patients over the age of 18, who underwent appendectomy between the years 2010-2020
Exclusion criteria
patients who did not undergo appendectomy patients who underwent appendectomy not using one of the accepted techniques do appendiceal stump closure
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| postoperative complications | 30 days | postoperative complications such as abscess formation, perforation, need of second surgery. complications measured with clavien-dindo classification |
Other
| Measure | Time frame | Description |
|---|---|---|
| costs of different appendiceal stump closure techniques | 30 days | costs of different appendiceal stump closure techniques |
Countries
Israel
Outcome results
None listed