Surgical Appendiceal Stump Closure - a Comparison Between Surgical Appendiceal Base Closure Methods, and Appendiceal Stump Complications.

Clalit Health Services

Status: Completed

Conditions: All Appendectomies Performed During the Designated Period in Single Medical Center

Treatments: Procedure: laparoscopic appendectomy using a clip for appendiceal stump closure; Procedure: laparoscopic appendectomy using a single endoloop for appendiceal stump closure; Procedure: laparoscopic appendectomy using two endoloops for appendiceal stump closure

Study type: Observational

Funder types: Other

Identifiers

NCT04886830

MeirMc - appendiceal stump

Details and patient eligibility

About

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.

Full 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.

Enrollment: 1,000 patients

Sex: All

Ages: 18 to 120 years old

Volunteers: No Healthy Volunteers

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

Trial design

1,000 participants in 3 patient groups

Appendectomy performed with single endoloop to appendiceal stump

Description:

Appendectomy performed with single endoloop for closure of appendiceal stump

Treatment:

Procedure: laparoscopic appendectomy using a single endoloop for appendiceal stump closure

Appendectomy performed with two endoloops to appendiceal stump

Description:

Appendectomy performed with two endoloops for closure of appendiceal stump

Treatment:

Procedure: laparoscopic appendectomy using two endoloops for appendiceal stump closure

Appendectomy performed with a clip to appendiceal stump

Description:

Appendectomy performed with a clip for closure of appendiceal stump

Treatment:

Procedure: laparoscopic appendectomy using a clip for appendiceal stump closure