Appendicectomy: assessment of stump invagination versus simple ligation: a prospective, randomized trial

Abstract

The appendix stump was ligated and doubly invaginated in 374 patients and was simply ligated in 361 in a prospective, randomized trial of 735 consecutive appendicectomies. The two groups were similar with respect to sex, age, degree of appendiceal inflammation and antibiotic treatment. The incidence of wound infection and postoperative pyrexia and the postoperative hospital stay showed no significant intergroup difference. The median operating time was slightly shorter in the group without invagination. Simple ligation facilitates and shortens appendicectomy. It produces no deformation of the caecal wall that subsequently may be mistaken for a caecal neoplasm. Simple ligation is therefore recommended as standard procedure in appendicectomy.

Surgical Audit: A Prospective Study of the Morbidity and Mortality of Acute Appendicitis

“…We suggest that the omission of inversion of the ligated appendix stump simplifies the appendectomy without any increase in morbidity. A similar conclusion was reported by Watters and Engstrom [11,12].…”

“…All patients (N = 317) 37 (12) Normal appendix (N = 39) 3 There was a higher representation (32%) of patients with perforated or gangrenous appendix whose appendectomy had not included a pursestring suture, and once these patients were excluded, there was no difference in the incidence of wound infection between the pursestring and no pursestring groups (Table 3).…”

Stump Invagination Versus Simple Ligation in Open Appendicectomy: A Systematic Review and Meta-Analysis

“…Eleven randomized controlled trials (RCTs) [2][3][4][5][6][7][8][9][10][11][12] involving 2634 patients were included and satisfied the inclusion criteria (SI: n ¼ 1302; SL: n ¼ 1332). Four RCTs were excluded due to unavailable full text.…”

“…There are numerous studies that have compared the advantages and disadvantages between SI and SL. [1][2][3][4][5][6][7][8][9][10][11][12] Many studies have shown that SL is superior to SI based on the shorter operative time, shorter hospital stay, and lower rate of postoperative ileus.…”

A comparative study of simple ligation and simple ligation with invagination of appendicular stump

“…17 So in our study no statistically significant differences in the rate of postoperative complications and postoperative hospital stay between the two groups was observed which is in consistent with other trials. 15,21,22 …”