Laparoscopic appendectomy in complicated appendicitis with compromised appendix base: a retrospective cohort study

Patients with compromised appendix base constitute a subgroup of patients with complicated appendicitis, and there is few available information.

To study the frequency of stump leaks and fistulae in patients with complicated appendicitis with compromised stump.

This is an observational, retrospective study of patients that underwent laparoscopic appendectomy with compromised appendix stump.

From 2015 to 2019, 158 patients with complicated appendicitis were operated, of them 54 had compromised base or stump. There were 66.7% men, with a mean age of 38.7 years. For stump closure, a simple knot was employed in 57.4%, and in 42.6% an invaginated suture was employed. Regarding complications, 16.7% developed intraabdominal abscess, 7.4% ileus and 7.4% had wound infection. We found one stump leak and one stump fistula. The mean length of stay was 5.4 days (range: 1-20). There were 5 reoperations, 4 for abscess drainage and 1 for stump leak.

Patients with acute complicated appendicitis with compromised appendicular base, laparoscopic surgery either with simple knot or with invaginated suture resulted in low frequency of stump leaks and fistula.