학술논문
Comparison of Burying the Appendiceal Stump Using Laparoscopic and Open Methods in Complicated Acute Appendicitis/ Komplike Akut Apandisitte Loporoskopik ve Acik Yontemle Guduk Gommenin Karsilastirmasi
Original Article
Original Article
Document Type
Report
Author
Source
The Medical Journal of Bakirkoy (Bakırkoy Tıp Dergisi). December 2020, Vol. 16 Issue 4, p336, 7 p.
Subject
Language
English
ISSN
1305-9319
Abstract
INTRODUCTION Acute appendicitis is seen in 25% of the patients admitted to the emergency department due to abdominal pain (12). Laparoscopic appendectomy has been shown to result in less postoperative [...]
Objective: The choice of laparoscopic technique in the treatment of complicated acute appendicitis (CAA) harbours debatable evidence because of higher rates of surgical complications such as postoperative intraabdominal abscess (POIIA). The aim of this study is to compare postoperative results of appendiceal stump (AS) ligation and its burial into the cecum using laparoscopic or open surgical techniques in patients with CAA. Method: This is a single-center and retrospective analysis of patients with CAA operated between May 2018 and April 2020. AS was intracorporeally knotted with silk and buried in the cecum with a purse-string suture (PSS). The patients were divided into open appendectomy (OA) and laparoscopic appendectomy (LA) groups. Data concerning demographic characteristics, intraoperative variables, hospital stay, surgical complications, morbidities, and postoperative findings were compared. Results: A total of 66 patients including 36 patients (54.54%) underwent LA and 30 patients had OA were enrolled in the study. Partial resection of cecum was performed in one patient in the OA group and two patients in the LA group with the help of a stapler due to cecal floor necrosis. The operative time and duration of hospital stay were significantly shorter in the LA group compared to the OA group. Surgical site infection and POIAA were significantly more frequent in the OA group (p Keywords: complicated acute appendicitis, open appendectomy, laparoscopic appendectomy, purse- string suture OZ Amac: Ameliyat sonrasi intraabdominal apse (POIIA) gibi daha yuksek cerrahi komplikasyonlar nedeniyle komplike akut apandisiti (CAA) olan hastalarda laparoskopik yaklasimin kullanimina iliskin tartismali kanitlar vardir. Bu calismanin amaci, CAA'li hastalarda laparoskopik veya acik cerrahi teknik kullanilarak apendiks gudugunun ligasyonu ve cekuma gomulme yonteminin postope- ratif son uclarini karsilastirmaktir. Yontem: 2Mayis 2018'den Nisan 2020'ye kadar ameliyat edilen CAA hastalarinin klinik kayitlarinin tek merkezli retrospektif bir analizidir. Apendiks guduk intrakorporeal olarak ipekle dugumlendi ve kese agzi suturu (PSS) ile cekuma gomuldu. Hastalar acik apendektomi (OA) ve laparoskopik apendektomi (LA) olarak iki gruba ayrildi. Demografik veriler, intraoperatif degiskenler, hastanede kalis sureleri, cerrahi komplikasyonlar, morbidite ve ameliyat sonrasi bulgular karsilastirildi. Bulgular: Calismaya 36 LA (% 54,54) ve 30 OA olmak uzere toplam 66 hasta dahil edildi. Cekum taban nekrozu nedeniyle OA grubunda 1, LA grubunda 2 hastaya stapler yardimi ile parsiyel cekum rezeksiyonu yapildi. LA grubunda ameliyat suresi ve hastanede kalis suresi OA grubuna gore anlamli olarak daha kisaydi. Cerrahi alan enfeksiyonu ve POIAA OA grubunda LA grubuna gore anlamli derecede yuksekti (p Anahtar kelimeler: komplike akut apandisit, acik apendektomi, laparoskopik apendektomi, gomme, kese agzi suturu
Objective: The choice of laparoscopic technique in the treatment of complicated acute appendicitis (CAA) harbours debatable evidence because of higher rates of surgical complications such as postoperative intraabdominal abscess (POIIA). The aim of this study is to compare postoperative results of appendiceal stump (AS) ligation and its burial into the cecum using laparoscopic or open surgical techniques in patients with CAA. Method: This is a single-center and retrospective analysis of patients with CAA operated between May 2018 and April 2020. AS was intracorporeally knotted with silk and buried in the cecum with a purse-string suture (PSS). The patients were divided into open appendectomy (OA) and laparoscopic appendectomy (LA) groups. Data concerning demographic characteristics, intraoperative variables, hospital stay, surgical complications, morbidities, and postoperative findings were compared. Results: A total of 66 patients including 36 patients (54.54%) underwent LA and 30 patients had OA were enrolled in the study. Partial resection of cecum was performed in one patient in the OA group and two patients in the LA group with the help of a stapler due to cecal floor necrosis. The operative time and duration of hospital stay were significantly shorter in the LA group compared to the OA group. Surgical site infection and POIAA were significantly more frequent in the OA group (p Keywords: complicated acute appendicitis, open appendectomy, laparoscopic appendectomy, purse- string suture OZ Amac: Ameliyat sonrasi intraabdominal apse (POIIA) gibi daha yuksek cerrahi komplikasyonlar nedeniyle komplike akut apandisiti (CAA) olan hastalarda laparoskopik yaklasimin kullanimina iliskin tartismali kanitlar vardir. Bu calismanin amaci, CAA'li hastalarda laparoskopik veya acik cerrahi teknik kullanilarak apendiks gudugunun ligasyonu ve cekuma gomulme yonteminin postope- ratif son uclarini karsilastirmaktir. Yontem: 2Mayis 2018'den Nisan 2020'ye kadar ameliyat edilen CAA hastalarinin klinik kayitlarinin tek merkezli retrospektif bir analizidir. Apendiks guduk intrakorporeal olarak ipekle dugumlendi ve kese agzi suturu (PSS) ile cekuma gomuldu. Hastalar acik apendektomi (OA) ve laparoskopik apendektomi (LA) olarak iki gruba ayrildi. Demografik veriler, intraoperatif degiskenler, hastanede kalis sureleri, cerrahi komplikasyonlar, morbidite ve ameliyat sonrasi bulgular karsilastirildi. Bulgular: Calismaya 36 LA (% 54,54) ve 30 OA olmak uzere toplam 66 hasta dahil edildi. Cekum taban nekrozu nedeniyle OA grubunda 1, LA grubunda 2 hastaya stapler yardimi ile parsiyel cekum rezeksiyonu yapildi. LA grubunda ameliyat suresi ve hastanede kalis suresi OA grubuna gore anlamli olarak daha kisaydi. Cerrahi alan enfeksiyonu ve POIAA OA grubunda LA grubuna gore anlamli derecede yuksekti (p Anahtar kelimeler: komplike akut apandisit, acik apendektomi, laparoskopik apendektomi, gomme, kese agzi suturu