Effectiveness of different appendiceal stump closure methods in laparoscopic appendectomy a network meta-analysis

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Laparoscopic appendectomy is a common procedure for acute appendicitis.
• Optimal stump closure technique remains debated among surgeons.
• Diverse methods exist, necessitating evidence-based guidance.

Purpose of the Study:

• To compare the efficacy and safety of various appendiceal stump closure methods in laparoscopic appendectomy.
• To identify the optimal technique for minimizing complications and operative time.
• To provide guidance for surgeons managing acute appendicitis.

Main Methods:

• A systematic literature search was performed across multiple databases up to December 2023.
• Included studies focused on laparoscopic appendectomy stump closure techniques.
• The primary outcome assessed was the incidence of total complications.

Main Results:

• 25 studies involving 3308 patients were analyzed.
• No significant difference in overall complications was found among closure methods (RR = 0.72, 95% CI: 0.53; 1.01).
• Superficial and deep infection risks were comparable across all techniques. Operative time was significantly longer for endoloop and intracorporeal sutures.

Conclusions:

• Appendiceal stump closure methods do not significantly differ in overall complication rates.
• Intracorporeal sutures and endoloop techniques are associated with longer operative times.
• Surgeons should consider operative duration when selecting a stump closure method.