Comparison of methods for closure of appendix stump during laparoscopic appendectomy using endoloops: Single surgeon experience

BACKGROUND: In this study, using single or double endoloops, with reference to the literature, we aimed to retrospectively assess the results for patients in our clinic who underwent a laparoscopic appendectomy.
METHODS: This study included 251 patients who were operated on by a single surgeon; 137 of the patients were male (54.6%) and 114 were female (45.4%). Patients were divided into two groups based on the type of endoloop procedure that was used. Group 1 included 107 patients for whom a single endoloop was used. Group II included 144 patients for whom double endoloop was used. Age, sex, duration of operation, length of hospital stay, pathological findings, perioperative appendix findings, perioperative abdominal findings, post-operative complications requiring hospitalization and wound infections were assessed for each patient. Patients were also assessed statistically for complications.
RESULTS: There were no significant differences in the demographic characteristics, perioperative surgery findings, pathological findings or duration of hospital stays between the two groups of the patients. However, the duration of operation was shorter in Group I (54.9±16.1 min) as compared to Group II (61.2±18.8 min). The incidence of complications requiring rehospitalization was statistically significantly lower in Group I (1.9%; n=2) as compared to Group II (9%; n=13) (p=0.018). There were no complications requiring re-operation for patients in Group I. In Group II, four patients (2.8%) required re-operation; however, this difference was not statistically significant. Concerning wound infection, there was also no significant difference between Group I (7.5% n=8) and Group II (4.9% n=7).
CONCLUSION: Using a double endoloop does not decrease the risk of post-operative complications, but it does increase the cost and the duration of the operation. We have concluded that using a single endoloop in a laparoscopic appendectomy may be more appropriate.

Laparoskopik apendektomilerde endoloop ile güdük kapama tekniði karþýlaþtýrýlmasý: Tek hekim deneyimi

AMAÇ: Bu çalýþmada kliniðimizde çift ya da tek endoloop kullanýlarak laparoskopik apendektomi yapýlan hastalarýmýzýn sonuçlarýný literatür eþliðinde geriye dönük olarak deðerlendirmeyi amaçladýk.
GEREÇ VE YÖNTEM: Çalýþmaya 137 erkek (%54.6) ve 114 kadýn (%45.4) olmak üzere tek cerrah tarafýndan ameliyat edilen toplam 251 hasta katýldý. Hastalarýn 107’si tek endoloop yönteminin kullanýldýðý grup I, 144’ü çift endoloop yönteminin kullanýldýðý grup II idi. Hastalarýn yaþ cinsiyet, ameliyat süresi, hastanede yatma süresi, patoloji bulgularý, perioperatif apendiks bulgularý, perioperatif batýn bulgularý, ameliyat sonrasý yatýþ gereken komplikasyonlar, ameliyat sonrasý operasyon gereken komplikasyonlar ve yara yeri enfeksiyonuna bakýldý. Komplikasyonlar istatistiksel olarak incelendi.
BULGULAR: Her iki grup arasýnda demografik özellikler, perioperatif ameliyat bulgularý, patoloji bulgularý, ameliyat sonrasý bulgular ve hastanede yatýþ süreleri arasýnda anlamlý fark izlenmedi. Ameliyat süreleri grup I’de (54.9±16,1) grup II’den (61.2±18,8) daha kýsa bulundu. Tekrar yatýþ gerektiren komplikasyonlar grup I’de (%1,9; n=2) grup II’den (%9; n=13) anlamlý olarak az bulundu (p=0.018). Tekrar ameliyat gereken komplikasyon grup I’de olmadý. Grup II’de dört hastada (%2.8) oldu, Ýstatistiksel olarak anlamlý fark bulunmadý. Yara yeri enfeksiyonu grup I (%7.5 n=8) ile grup II (%4.9 n=7) arasýnda anlamlý fark izlenmedi.
TARTIÞMA: Çift endoloop kullanmak ameliyat sonrasý komlikasyonlarý azaltmamakla birlikte ameliyat maliyetini artýrmakta ve ameliyat süresini uzatmaktadýr. Laparoskopik apendektomide loop kullanýmýnda tek loop kullanmanýn daha uygun olacaðý kanaatindeyiz.