Comparative study of three ways for treating the appendiceal stump after acute appendicitis under laparoscopy

Abstract

Objective To investigate the advantages and disadvantages of purse-string suture, Hem-o-lok clip and double thread ligation in the treatment of appendiceal stump. Methods A retrospective study was conducted on 237 acute appendicitis patients who underwent laparoscopic appendectomy at Nanjing Jiangbei Hospital from July 2021 to April 2023. According to the treatment, the patients were divided into purse-string suture group (n=48), Hem-o-lok clip group (n=152) and double thread ligation group (n=37). The baseline data, surgical time, intraoperative bleeding, length of hospital stay, total hospitalization costs, and incidence of postoperative complications among three different treatment methods were compared. Results There was no significant in operation time, blood loss, and hospital stay among three groups (P＞0.05). there was significant difference in total hospitalization cost among three groups (F=5.823, P=0.003), and that in double thread ligation group was (9 809.1±1 199.7) yuan, which was significantly lower than that in the purse-string suture group ［(10 355.0±1 133.7) yuan］ and Hem-o-lok clip group ［(10 541.6±1 179.3) yuan］ (P＜0.05). The incidence of complications in the purse string suture group was 2.1% (1/48), the Hem-o-lok clip group was 2.0% (3/152), and the double thread ligation group was 2.7% (1/37). There was no statistically significant difference in the incidence of complications among the three groups (P＞0.05). Conclusion The three methods to secure the appendiceal stump are safe and effective, but double thread ligation is cost-saving than purse-string suture and Hem-o-lok clip.

Keywords

• acute appendicitis
• laparoscopic appendectomy
• purse-string suture
• hem-o-lok clip
• double filament ligation