The effect of stump ligation techniques on operative time in laparoscopic appendectomy

N. Kutluer, A. Aksu, U. Aday, Hakan Kanat, A. Böyük, Serhat Doğan
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Abstract

Introduction: We aimed to the of ligation techniques on Material The underwent laparoscopic appendectomy in our General Surgery Clinic January 2016 and August 2018 were retrospectively reviewed. The effects of stump ligation techniques used in the operations on operative times were evaluated. Results: Sixty consecutive patients were screened and 3 groups, 20 patients in each group, were formed based on stump ligation techniques. Extracorporeal knotting – loop ligation was used in Group 1; intracorporeal knotting was used in the Group 2; hem-o-lok clip was used in Group 3.There was no statistically significant difference between the groups in terms of gender distribution and mean age. However, there was a significant difference between the hem-o-lok clip group (Group III) and the intracorporeal knot group (Group II) in terms of operative time. Group III had a shorter operative time. The Group III patients had the shortest operative time, while the Group II patients had the longest operative time ( p < 0.05). Conclusions: We can speculate that hem-o-lok clip among the stump ligation techniques reduces the cost, is a safe method and shortens the operative time. However, prospective randomized studies with a large sample size comparing different techniques are needed to determine the ideal treat-ment procedure. At the same time, stapler use may be considered in cases where the base of the appendix is too inflamed or necrosed. It is known that the use of a stapler and endoloop is more expensive than all other techniques. However, the most important issue for the surgeon is patient safety; therefore the most appropriate technique should be preferred.
残端结扎技术对腹腔镜阑尾切除术手术时间的影响
我们回顾性分析了2016年1月至2018年8月在我院普外科门诊行腹腔镜阑尾切除术的患者。评估手术中使用的残端结扎技术对手术时间的影响。结果:连续筛选60例患者,根据残端结扎技术分为3组,每组20例。第一组采用体外打结环结扎术;第二组采用胞内打结;第三组采用hem-o-lok夹。在性别分布和平均年龄方面,组间无统计学差异。然而,hem-o-lok夹组(III组)与体内结组(II组)在手术时间上有显著差异。III组手术时间较短。III组患者手术时间最短,II组患者手术时间最长(p < 0.05)。结论:在残端结扎技术中,hem-o-lok夹可降低成本,是一种安全的结扎方法,可缩短手术时间。然而,需要通过大样本量的前瞻性随机研究来比较不同的技术,以确定理想的治疗方法。同时,在阑尾底部过度发炎或坏死的情况下,可以考虑使用订书机。众所周知,使用订书机和endoloop比所有其他技术都要昂贵。然而,对外科医生来说最重要的问题是病人的安全;因此,应该优先选择最合适的技术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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