Surgical Appendiceal Stump Closure - a Comparison Between Surgical Appendiceal Base Closure Methods, and Appendiceal Stump Complications.
Condition: All Appendectomies Performed During the Designated Period in Single Medical Center
Study type: Observational

Summary: 
      comparing the rate and severity of postoperative complication after LA in regards of
      different appendiceal stump closure techniques. Data regarding different operative and
      postoperative parameters was collected from all appendectomies performed in a single medical
      center in Israel during the years 2010-2020.
    

Detailed description: 
      To date, laparoscopic appendectomy (LA) is still the most common surgical procedure done in
      an acute setting [1,2]. Most patients presenting to the ER with acute appendicitis, will
      undergo an appendectomy in the same hospital admission [3]. The widely practiced technique
      for LA, is the placement of access trocars in a proper triangulation, insufflation of the
      abdomen to create a pneumoperitoneum, dissecting through the mesoappendix with electrothermal
      devices to expose the appendiceal base, appendiceal stump closure and appendiceal resection,
      and finally extraction of the resected appendix [4].

      There are multiple techniques to close and secure the appendiceal stump. The use of staples,
      clips and prepared surgical knots such as the ENDOLOOP with PDS suture is widely in use.
      Although requiring less manual surgical skill to use, the costs of staples and clips are
      higher than the prepared suture, and the use of larger trocars is obligatory [4].

      Yet, data comparing the postoperative efficacy and safety of these appendiceal stump closure
      techniques is scarce.

      The aim of this study is to compare the postoperative efficacy and safety of appendiceal
      stump closure techniques, and to assess their cost effectiveness.

      This is a retrospective, single center study, comparing the rate and severity of
      postoperative complication after LA. Data regarding different operative and postoperative
      parameters was collected from all appendectomies performed in a single medical center in
      Israel during the years 2010-2020.
    

Intervention name(s): laparoscopic appendectomy using a single endoloop for appendiceal stump closure; laparoscopic appendectomy using two endoloops for appendiceal stump closure; laparoscopic appendectomy using a clip for appendiceal stump closure
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): laparoscopic appendectomy using a single endoloop for appendiceal stump closure before resecting the appendix; laparoscopic appendectomy using a two endoloops for appendiceal stump closure before resecting the appendix; laparoscopic appendectomy using an endoclip for appendiceal stump closure before resecting the appendix
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        all patients over the age of 18, who underwent appendectomy between the years 2010-2020
      
Keywords: laparoscopic appendectomy; appendiceal stump; endoloop