A Comparison of Endoloop Ligatures and Nonabsorbable Polymeric Clips for the Closure of the Appendicular Stump During
Zenon Pogorelić1,2, Boris Kostovski2, Ana Jerončić3
11 Department of Pediatric Surgery, Split University Hospital , Split, Croatia .
Insights
Nonabsorbable polymeric clips offer a simpler, cost-effective alternative for laparoscopic appendectomy stump closure in children, reducing operative time compared to endoloop ligatures without increasing complications.
Area of Science:
- Pediatric surgery
- Surgical techniques
- Minimally invasive surgery
Background:
- Laparoscopic appendectomy is a common procedure in pediatric surgery.
- Effective stump closure is crucial to prevent complications.
- Comparing different stump closure methods is essential for optimizing outcomes.
Purpose of the Study:
- To compare the clinical outcomes of nonabsorbable polymeric clips versus endoloop ligatures for laparoscopic appendix stump closure in children.
- To evaluate complication rates, operative time, hospital stay, and costs associated with each technique.
Main Methods:
- Prospective trial involving 277 children undergoing laparoscopic appendectomy.
- Patients were divided into two groups: polymeric clips (101) and endoloop ligature (176).
- Investigated intraoperative and postoperative complications for both appendiceal stump closure techniques.
Main Results:
- No intraoperative complications were observed in either group.
- Overall postoperative complication rate was 6.1% with no significant difference between groups (P = .546).
- Polymeric clips significantly reduced operative time (median 10 minutes shorter) and hospital stay (P = .008), with lower costs (€17.64 vs €34.16).
Conclusions:
- Nonabsorbable polymeric clips provide a safe and effective method for laparoscopic appendix stump closure in pediatric patients.
- This technique offers advantages in reduced operative time and cost-effectiveness compared to endoloops.
- Polymeric clips represent a simpler alternative to endoloops for laparoscopic appendectomy stump closure.
Background:
The aim of this prospective trial was to evaluate the clinical outcomes of nonabsorbable polymeric clips in laparoscopic appendix stump closure in children by comparing the endoloop ligature.
Patients And Methods:
From June 2011 to June 2016, 277 children who underwent laparoscopic appendectomy were included in the study. The patients were divided into two groups based on the technique used for appendiceal stump closure: there were 101 patients in the polymeric clips group and 176 in the endoloop group. The risk of intraoperative and postoperative complications was investigated for two different techniques to close the appendiceal stump.
Results:
Among the 277 patients who underwent laparoscopic appendectomy, no intraoperative complications and 17 (6.1%) postoperative complications were recorded. There were no significant differences between the groups with respect to the postoperative complications (P = .546). The median length of the operation was 10 minutes shorter when the polymeric clips were used (P < .001). The median hospital stay was also shorter in the polymeric clips group (P = .008). Costs of polymeric clip were significantly lower (€ 17.64) compared to endoloop (€ 34.16).
Conclusions:
Closure of the appendix stump with polymeric nonabsorbable clips in laparoscopic appendectomy reduces operative time and may be a cost-effective and simpler alternative to widely used endoloops.
