Comparison of Laparoscopic Methods of Management of Appendix Stump

Abstract

INTRODUCTION: Today, laparoscopic appendectomy (LAE) is the ‘golden standard’ of the treatment for acute appendicitis. However, the choice of the method of management of the appendix stump (AS) causes much debate.

AIM: Comparative analysis of invagination and ligation methods of management of the appendix stump in LAE.

MATERIALS AND METHODS: The analysis included data from 130 patients who underwent LAE. An analysis and comparison of the invagination and ligation methods of management of AS are presented.

RESULTS: There were no significant differences in the frequency of mild postoperative complications of LAE, severity of pain syndrome and length of hospital treatment. The difference was in the time of the surgical intervention, which was longer in the group of patients with AS managed using the invagination method. The frequency of infiltrates of the right iliac fossa was lower in the group of AS management using invagination method.

CONCLUSION: This clinical study demonstrated the effectiveness, safety and availability of the invagination method of AS management compared to the ligation method. A disadvantage of the invagination method is the requirements to the surgeon’s practical skills and a significant increase in the length of the operation. The management of the AS by immersing it with the intracorporal suture into the cecum cupula can be recommended for use in the everyday surgical practice.

Keywords

acute appendicitis / laparoscopic appendectomy / appendix / vermiform process / appendix stump / method of management of appendix stump

References

[1] Ukhanov AP, Zakharov DV, Bol'shakov SV, et al. Laparoscopic appen-dectomy — the «gold standard» technique for all kinds of acute appendicitis. Endoscopic Surgery. 2018;24(2):3–7. doi: 10.17116/endoskop20182423 EDN: UTLJMF

[2] Baymakov SR, Zhanibekov ShSh, Ibragimov DI. Opyt laparoskopicheskoy appendektomii u patsiyentov s ostrym appenditsitom. Zhurnal Teoreticheskoy i Klinicheskoy Meditsiny. 2022;(4):159. (In Russ.) EDN: BJZGGK

[3] Panasyuk AI, Inozemtsev EO, Sandakov PI, et al. Arterial Thrombosis of Vermiform Appendix Resulting in Gangrenous Appendicitis. Experimental and Clinical Gastroenterology. 2022;(11):259–261.

[4] doi: 10.31146/1682-8658-ecg-207-11-259-261 EDN: XLXMMG

[5] Butov MA, Shebbi R, Zhestkova TV. Possibilities of Pathogenetic Therapy in Patients with Functional Pathology of the Digestive System. Science of the Young (Eruditio Juvenium). 2023;11(2):169–177. doi: 10.23888/HMJ2023112169-177 EDN: FIWBKJ

[6] Otdelnov LA, Mastyukova AM. Difficult cases of differential diagnosis of acute appendicitis. Research'n Practical Medicine Journal. 2021;8(3): 133–139. doi: 10.17709/2410-1893-2021-8-3-12 EDN: YRSPCI

[7] Galimov OV, Khanov VO, Minigalin DM, et al. Laparoscopic Surgery for Acute Appendicitis Complicated by Peritonitis. Creative Surgery and Oncology. 2023;13(1):33–38. doi: 10.24060/2076-3093-2023-13-1-33-38 EDN: TIQDHR

[8] Zuiki T, Ohki J, Miyahara Y, et al. Appendiceal stump inversion with a purse-string suture in laparoscopic appendectomy. Ann Laparosc Endosc Surg. 2017;2:76. doi: 10.21037/ales.2017.03.13

[9] Malkov IS, Mamedov TA, Shakirov MI, et al. Complicated destructive appendicitis: finding the optimal treatment method. Kazan Medical Journal. 2021;102(5):751–756. doi: 10.17816/KMJ2021-751 EDN: JSECNH

[10] Gavrilyuk VP, Severinov DA, Ovcharenko AM. Surgical Tactics in Perforations of Stomach and Small Intestine in Children (Literature Review). I.P. Pavlov Russian Medical Biological Herald. 2023;31(3):489–500. doi: 10.17816/PAVLOVJ111829 EDN: OYMCUG

[11] Musaev US, Aitnazarov MS, Kenzhekulov KK, Baltabaev AI. Efficiency of measures for prevention of wound complications in acute appendicitis. Health Care of Kyrgyzstan. 2021;(4):74–78. doi: 10.51350/zdravkg2021124974 EDN: VVTJHH

RIGHTS & PERMISSIONS

Eco-Vector