Comparison the effect of stump closure by endoclips versus endoloop on the duration of surgery and complications in patients under laparoscopic appendectomy: A randomized clinical trial

Abstract

Background:Laparoscopic appendectomy is a well-described surgical technique. However, concerns still exist regarding whether the closure of the appendiceal stump should be done with a clip, an endoloop, or other techniques. In this study, the effect of stump closure on duration of surgery and complications by endoclips was compared with endoloop in patients under laparoscopic appendectomy. The study was carried out as a prospective randomized clinical trial between 2013 and 2015 in Shariati Hospital of Tehran.Materials and Methods:Seventy-six patients under laparoscopic appendectomy were enrolled and randomly assigned to receive either endoclips or endoloop for stump closure. The results in terms of the operating time, length of hospital stay, and the complications were compared and analyzed between two groups. After collecting the essential data by using a checklist and examination of patients, the data were analyzed with SPSS.Results:The mean age was 23.13 ± 5.07 years and 44.7% of the patients were male. Moreover, in this study, it was seen that the mean duration of surgery was 23.2 min versus 21.5 min in endoloop and endoclips groups, respectively (P = 0.021). There was no difference between hospital stay among two groups (P > 0.05). Furthermore, the complications were same in two groups (P > 0.05).Conclusion:The effect of stump closure with endoloop versus endoclips is not different for complications, but the duration of surgery was shorter in endoclips method. Both methods could be used based on the opinion of the surgeon without expecting a statistically significant difference in the results.

Factors affecting the length of hospital stay after laparoscopic appendectomy: A single center study

“…The commonly used methods are silk ligation, Endoloop ligation, Hem-o-lok vascular clamp occlusion, and endo-gastrointestinal anastomosis (Endo-GIA) stapler cutting and closure [ 7 – 11 , 14 – 16 , 23 – 28 ]. Vascular clamps were associated with shorter surgical time and were cheaper [ 12 , 13 , 15 , 16 ]. However, they had increased costs compared with simple ligation.…”

“…The Hem-o-lok vascular clamp was stiff, and therefore it might stimulate the surface of the bowel during peristalsis of the intestine, causing abdominal pain in the short term after surgery. Sadat-Safvi et al [ 15 ] found that the incidence of postoperative abdominal pain after vascular clamp treatment of appendix stump was as high as 76%. However, a silk thread is soft and does not cause similar irritation to the intestinal tract.…”

“…Laparoscopic appendectomy has become the preferred surgical method for appendicitis due to less trauma and faster recovery [4][5][6]. Previous studies demonstrated that the hospital stay was 1-8 days after laparoscopic appendectomy [4,[6][7][8][9][10][11][12][13][14][15][16]. The shorter hospital stay might lead to decreased cost and higher percentage of bed utilization.…”

Comparison of methods for closure of appendix stump during laparoscopic appendectomy using endoloops: Single surgeon experience

“…Çelik et al Comparison of methods for closure of appendix stump during laparoscopic appendectomy using endoloops Beldi et al [7] Single endoloop Safavi et al [14] Endoclips Lucchi et al [12] Single endoloop In a study of 208 patients by Beldi et al, [7] a single endoloop was used in 109 patients, while double endoloop was used in the remaining 99 patients. Post-operative complications occurred in five patients (4.6%) in the single endoloop group and in five patients (5.1%) in the double endoloop group.…”

“…Ulus Travma Acil Cerrahi Derg 2019;25:616-621. [10][11][12][13][14][15] However, publications comparing the double endoloop or intracorporeal knot method with a single endoloop or intracorporeal knot method are scarce. [6] In our study, we aimed to retrospectively assess the results for the patients in our clinic who underwent a laparoscopic appendectomy using a single or double endoloop, with reference to the literature.…”