Partial cecum resection using endostapler in acute complicated appendicitis with appendiceal base necrosis

Area of Science:

• Gastrointestinal Surgery
• Laparoscopic Procedures
• Appendicitis Management

Background:

• Stump closure methods for complicated appendicitis, particularly with appendix base necrosis or perforation, remain a subject of debate.
• Effective surgical techniques are crucial for managing these complex cases.

Purpose of the Study:

• To assess the efficacy and safety of laparoscopic partial cecum resection with an endostapler in patients experiencing appendix base necrosis or perforation.
• To provide an alternative surgical approach for complicated appendicitis.

Main Methods:

• A retrospective analysis of 36 patients who underwent laparoscopic partial cecum resection using an endostapler between 2015 and 2020.
• The procedure involved resection within a safe surgical margin for acute complicated appendicitis with appendiceal base necrosis or perforation.
• Data collected included demographics, operative time, hospital stay, and intra/post-operative complications.

Main Results:

• No intraoperative complications were reported.
• The mean operative time was 104.75 ±34.96 days, and the mean hospital stay was 4.58 ±2.82 days.
• Post-operative complications occurred in 13.7% of patients (wound infection, ileus, intraabdominal abscess), with no instances of stapler line leak.

Conclusions:

• Laparoscopic partial cecum resection with an endostapler is a safe and effective surgical option.
• This technique is particularly beneficial in cases of appendix base necrosis, perforation, or severe cecal base inflammation.
• The study supports the use of endostaplers in laparoscopic appendectomy for complex appendicitis scenarios.