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Laparoskopik Apendektomide Apendiks Güdüğünün Hemolok Klip İle Kapanması

Year 2022, Volume: 39 Issue: 2, 459 - 462, 18.03.2022

Abstract

Laparoskopik apendektomide (LA) apendiks güdüğünü kapamak için birçok teknik kullanılmaktadır. Bu çalışma ile apendiks güdüğünün kapatılmasında Hemolok klip kullanımının güvenilirliğini ve kullanılabilirliğini araştırmayı amaçladık. Ocak 2015 ile Ekim 2018 tarihleri arasında Hemolok klipleri ile güdük kapatılması planlanan ve LA uygulanan 87 hasta üç ayrı cerrah tarafından opera edildi. Bunların arasında 9 (%10.3) hastaya hemolok klip uygulaması yapılamadı. Geriye kalan 78 hasta analizlere dahil edildi. Hastaların demografik verileri, ameliyat süreleri, hastanede kalış süreleri ve komplikasyonları irdelendi. Hemolok kullanılan 78 hastanın 39’u (%50) erkek 39’u (%50) kadındı. Yaş ortalaması 28,55 ± 10,61 (18-73) yıldı. Ortanca ameliyat süresi 51,3 (30-160) dakika idi. Hastaların 22 tanesinde (%28,2) komplike apandisit (perfore, nekroze gibi) hali mevcuttu. Hastalara ameliyat sonrası oral diet başlama zamanı 10.48 (4-36) saat idi ve hastanede yatış süresi ortanca 22,92 (6-72) saat idi. Hemolok kullanılan 4 hastada (%5,1) postoperatif komplikasyon gelişti. Bunların 2'si karın ağrısı, 1’i karın şişliği ve 1’i ise trokar yeri enfeksiyonuydu. Bunların hiç biri hemolok kullanımına bağlı değildi. Hastaların hiçbirinde tekrar ameliyata ihtiyaç duyulmadı. Hemolok kullanılamayan hastaların apendiks çapı hemolok kullanılan hastalardan anlamlı olarak daha kalındı (p = 0.003). LA yapılan olgularda apendiks güdüğünün hemolok ile kapatılması uygun, güvenli, hızlı ve kost-efektif bir tekniktir. Burada önemli olan, apendiks çapının 1 cm ve altında olmasının yanı sıra apendiks güdüğünün aşırı derecede ödemli ve nekroze olmamasıdır.

References

  • 1. Al-Temimi, M.H., Berglin, M.A., Kim, E.G., Tessier, D.J., Johna, S.D., 2017. Endostapler versus Hem-O-Lok clip to secure the appendiceal stump and mesoappendix during laparoscopic appendectomy. Am. J. Surg. 214(6), 1143-1148.
  • 2. Andersson, R.E., 2014. Short-term complications and long-term morbidity of laparoscopic and open appendicectomy in a national cohort. Br. J. Surg. 101(9), 1135-1142.
  • 3. Arcovedo, R., Barrera, H., Reyes, H.S., 2007. Securing the appendiceal stump with the Gea extracorporeal sliding knot during laparoscopic appendectomy is safe and economical. Surg. Endosc. 21(10), 1764-1767.
  • 4. Baird, D.L.H., Simillis, C., Kontovounisios, C., Rasheed, S., Tekkis, P.P., 2017. Acute appendicitis. BMJ. 357(j1703.
  • 5. Colak, E., Kement, M., Ozlem, N., Mutlu, T., Yildirim, K., Gurer, A., Aktimur, R., 2013. A comparison of nonabsorbable polymeric clips and endoloop ligatures for the closure of the appendicular stump in laparoscopic appendectomy: a prospective, randomized study. Surg. Laparosc. Endosc. Percutan. Tech. 23(3), 255-258.
  • 6. Delibegović, S., Iljazović, E., Katica, M., Koluh, A., 2011. Tissue reaction to absorbable endoloop, nonabsorbable titanium staples, and polymer Hem-o-lok clip after laparoscopic appendectomy. JSLS. 15(1), 70-76.
  • 7. Delibegović, S., Matović, E., 2009. Hem-o-lok plastic clips in securing of the base of the appendix during laparoscopic appendectomy. Surg. Endosc. 23(12), 2851-2854.
  • 8. Gomes, C.A., Junior, C.S., De Peixoto, R.O., Netto, J.M., Gomes, C.C., Gomes, F.C., 2013. Appendiceal stump closure by metal endoclip in the management of complicated acute appendicitis. World J. Emerg. Surg. 8(1), 35.
  • 9. Hanssen, A., Plotnikov, S., Dubois, R., 2007. Laparoscopic appendectomy using a polymeric clip to close the appendicular stump. JSLS. 11(1), 59-62.
  • 10. Hue, C.S., Kim, J.S., Kim, K.H., Nam, S.H., Kim, K.W., 2013. The usefulness and safety of Hem-o-lok clips for the closure of appendicular stump during laparoscopic appendectomy. J. Korean Surg. Soc. 84(1), 27-32.
  • 11. Kazemier, G., In't Hof, K.H., Saad, S., Bonjer, H.J., Sauerland, S., 2006. Securing the appendiceal stump in laparoscopic appendectomy: evidence for routine stapling? Surg. Endosc. 20(9), 1473-1476.
  • 12. Lucchi, A., Berti, P., Grassia, M., Siani, L.M., Gabbianelli, C., Garulli, G., 2017. Laparoscopic appendectomy: Hem-o-lok versus Endoloop in stump closure. Updates Surg. 69(1), 61-65.
  • 13. Masoomi, H., Mills, S., Dolich, M.O., Ketana, N., Carmichael, J.C., Nguyen, N.T., Stamos, M.J., 2011. Comparison of outcomes of laparoscopic versus open appendectomy in adults: data from the Nationwide Inpatient Sample (NIS), 2006-2008. J. Gastrointest. Surg. 15(12), 2226-2231.
  • 14. Meng, M.V., 2006. Reported failures of the polymer self-locking (Hem-o-lok) clip: review of data from the Food and Drug Administration. J. Endourol. 20(12), 1054-1057.
  • 15. Miyano, G., Urao, M., Lane, G.J., Kato, Y., Okazaki, T., Yamataka, A., 2011. A prospective analysis of endoloops and endostaples for closing the stump of the appendix in children. J. Laparoendosc. Adv. Surg. Tech. A. 21(2), 177-179.
  • 16. Ohtani, H., Tamamori, Y., Arimoto, Y., Nishiguchi, Y., Maeda, K., Hirakawa, K., 2012. Meta-analysis of the results of randomized controlled trials that compared laparoscopic and open surgery for acute appendicitis. J. Gastrointest. Surg. 16(10), 1929-1939.
  • 17. Partecke, L.I., Kessler, W., Patrzyk, M., Heidecke, C.D., Bernstorff, W.V., 2011. Comparison Among Different Closure Methods of the Appendicular Stump in Laparoscopic Appendectomy. Surg. Technol. Int. 21, 85-91.
  • 18. Partecke, L.I., Kessler, W., Von Bernstorff, W., Diedrich, S., Heidecke, C.D., Patrzyk, M., 2010. Laparoscopic appendectomy using a single polymeric clip to close the appendicular stump. Langenbecks Arch. Surg. 395(8), 1077-1082.
  • 19. Rickert, A., Bönninghoff, R., Post, S., Walz, M., Runkel, N., Kienle, P., 2012. Appendix stump closure with titanium clips in laparoscopic appendectomy. Langenbecks Arch. Surg. 397(2), 327-331.
  • 20. Sabbagh, C., Cosse, C., Dupont, H., Ntouba, A., Lion, T., Regimbeau, J.M., 2014. Ambulatory management of gastrointestinal emergencies: what are the current literature data? J. Visc. Surg. 151(1), 23-27.
  • 21. Sahm, M., Kube, R., Schmidt, S., Ritter, C., Pross, M., Lippert, H., 2011. Current analysis of endoloops in appendiceal stump closure. Surg. Endosc. 25(1), 124-129.
  • 22. Sajid, M.S., Rimple, J., Cheek, E., Baig, M.K., 2009. Use of endo-GIA versus endo-loop for securing the appendicular stump in laparoscopic appendicectomy: a systematic review. Surg. Laparosc. Endosc. Percutan. Tech. 19(1), 11-15.
  • 23. Sammalkorpi, H.E., Mentula, P., Leppäniemi, A., 2014. A new adult appendicitis score improves diagnostic accuracy of acute appendicitis--a prospective study. BMC Gastroenterol. 14, 114.
  • 24. Sauerland, S., Jaschinski, T., Neugebauer, E.A., 2010. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst. Rev. 10, CD001546.
  • 25. Semm, K.,1983. Endoscopic appendectomy. Endoscopy. 15(2), 59-64.
  • 26. Shaikh, F.M., Bajwa, R., Mcdonnell, C.O., 2015. Management of appendiceal stump in laparoscopic appendectomy--clips or ligature: a systematic review and meta-analysis. J. Laparoendosc. Adv. Surg. Tech. A. 25(1), 21-27.
  • 27. Shalaby, R., Arnos, A., Desoky, A., Samaha, A.H., 2001. Laparoscopic appendectomy in children: evaluation of different techniques. Surg. Laparosc. Endosc. Percutan. Tech. 11(1), 22-27.
  • 28. Simforoosh, N., Sarhangnejad, R., Basiri, A., Ziaee, S.A., Sharifiaghdas, F., Tabibi, A., Nouralizadeh, A., Kashi, A.H., Moosanejad, N., 2012. Vascular clips are safe and a great cost-effective technique for arterial and venous control in laparoscopic nephrectomy: single-center experience with 1834 laparoscopic nephrectomies. J. Endourol. 26(8), 1009-1012.
  • 29. Soll, C., Wyss, P., Gelpke, H., Raptis, D.A., Breitenstein, S., 2016. Appendiceal stump closure using polymeric clips reduces intra-abdominal abscesses. Langenbecks Arch. Surg. 401(5), 661-666.
  • 30. Wagner, M., Aronsky, D., Tschudi, J., Metzger, A., Klaiber, C., 1996. Laparoscopic stapler appendectomy. A prospective study of 267 consecutive cases. Surg. Endosc. 10(9), 895-899.

Appendiceal stump closure with hem-o-lok clips in laparoscopic appendectomy

Year 2022, Volume: 39 Issue: 2, 459 - 462, 18.03.2022

Abstract

Various appendiceal stump closure techniques are used in laparoscopic appendectomy (LA). The purpose of this study was to investigate the safety and usefulness of the Hemolok clip for the closure of appendicular stumps in LA. From January 2015 to October 2018, a total of 87 consecutive patients underwent LA by three surgeons with planned use of Hemolok clips. In 9 (10.3%) patients, hemolok clips could not be used for the closure of the stump. The remaining 78 patients were included for analysis. The demographics, operation time, hospitalization time and complications were recorded. Of these 78 patients, 39 (50%) were male and 39 (50%) were female. The mean age was 28.55 ± 10.61 (18-73) years and median operation time was 51.3 (30-160) minutes. Twenty-two (28.2%) of the patients had complicated appendicitis (perforated, necrotic). The median time until oral diet allowance was 10.48 (4-36) hours after surgery and median hospitalization time was 22.92 (6-72) hours. Postoperative complications were seen in 4 (5.1%) patients; two had abdominal pain, one had abdominal distention and one had trocar site infection. None of the complications were associated with the use of hemolok clips. None of the patients required reoperation. The appendiceal diameter was found to be greater in patients without hemolok closure compared to patients with hemolok closure (p = 0.003). The closure of the appendix stump with hemolok in LA is an appropriate, safe, fast and cost-effective technique. It is important to note that the appendix stump should not be extremely edematous or necrotic in order to be able to apply hemolok clips. Ideally, the stump should have a diameter smaller than 1 cm.

References

  • 1. Al-Temimi, M.H., Berglin, M.A., Kim, E.G., Tessier, D.J., Johna, S.D., 2017. Endostapler versus Hem-O-Lok clip to secure the appendiceal stump and mesoappendix during laparoscopic appendectomy. Am. J. Surg. 214(6), 1143-1148.
  • 2. Andersson, R.E., 2014. Short-term complications and long-term morbidity of laparoscopic and open appendicectomy in a national cohort. Br. J. Surg. 101(9), 1135-1142.
  • 3. Arcovedo, R., Barrera, H., Reyes, H.S., 2007. Securing the appendiceal stump with the Gea extracorporeal sliding knot during laparoscopic appendectomy is safe and economical. Surg. Endosc. 21(10), 1764-1767.
  • 4. Baird, D.L.H., Simillis, C., Kontovounisios, C., Rasheed, S., Tekkis, P.P., 2017. Acute appendicitis. BMJ. 357(j1703.
  • 5. Colak, E., Kement, M., Ozlem, N., Mutlu, T., Yildirim, K., Gurer, A., Aktimur, R., 2013. A comparison of nonabsorbable polymeric clips and endoloop ligatures for the closure of the appendicular stump in laparoscopic appendectomy: a prospective, randomized study. Surg. Laparosc. Endosc. Percutan. Tech. 23(3), 255-258.
  • 6. Delibegović, S., Iljazović, E., Katica, M., Koluh, A., 2011. Tissue reaction to absorbable endoloop, nonabsorbable titanium staples, and polymer Hem-o-lok clip after laparoscopic appendectomy. JSLS. 15(1), 70-76.
  • 7. Delibegović, S., Matović, E., 2009. Hem-o-lok plastic clips in securing of the base of the appendix during laparoscopic appendectomy. Surg. Endosc. 23(12), 2851-2854.
  • 8. Gomes, C.A., Junior, C.S., De Peixoto, R.O., Netto, J.M., Gomes, C.C., Gomes, F.C., 2013. Appendiceal stump closure by metal endoclip in the management of complicated acute appendicitis. World J. Emerg. Surg. 8(1), 35.
  • 9. Hanssen, A., Plotnikov, S., Dubois, R., 2007. Laparoscopic appendectomy using a polymeric clip to close the appendicular stump. JSLS. 11(1), 59-62.
  • 10. Hue, C.S., Kim, J.S., Kim, K.H., Nam, S.H., Kim, K.W., 2013. The usefulness and safety of Hem-o-lok clips for the closure of appendicular stump during laparoscopic appendectomy. J. Korean Surg. Soc. 84(1), 27-32.
  • 11. Kazemier, G., In't Hof, K.H., Saad, S., Bonjer, H.J., Sauerland, S., 2006. Securing the appendiceal stump in laparoscopic appendectomy: evidence for routine stapling? Surg. Endosc. 20(9), 1473-1476.
  • 12. Lucchi, A., Berti, P., Grassia, M., Siani, L.M., Gabbianelli, C., Garulli, G., 2017. Laparoscopic appendectomy: Hem-o-lok versus Endoloop in stump closure. Updates Surg. 69(1), 61-65.
  • 13. Masoomi, H., Mills, S., Dolich, M.O., Ketana, N., Carmichael, J.C., Nguyen, N.T., Stamos, M.J., 2011. Comparison of outcomes of laparoscopic versus open appendectomy in adults: data from the Nationwide Inpatient Sample (NIS), 2006-2008. J. Gastrointest. Surg. 15(12), 2226-2231.
  • 14. Meng, M.V., 2006. Reported failures of the polymer self-locking (Hem-o-lok) clip: review of data from the Food and Drug Administration. J. Endourol. 20(12), 1054-1057.
  • 15. Miyano, G., Urao, M., Lane, G.J., Kato, Y., Okazaki, T., Yamataka, A., 2011. A prospective analysis of endoloops and endostaples for closing the stump of the appendix in children. J. Laparoendosc. Adv. Surg. Tech. A. 21(2), 177-179.
  • 16. Ohtani, H., Tamamori, Y., Arimoto, Y., Nishiguchi, Y., Maeda, K., Hirakawa, K., 2012. Meta-analysis of the results of randomized controlled trials that compared laparoscopic and open surgery for acute appendicitis. J. Gastrointest. Surg. 16(10), 1929-1939.
  • 17. Partecke, L.I., Kessler, W., Patrzyk, M., Heidecke, C.D., Bernstorff, W.V., 2011. Comparison Among Different Closure Methods of the Appendicular Stump in Laparoscopic Appendectomy. Surg. Technol. Int. 21, 85-91.
  • 18. Partecke, L.I., Kessler, W., Von Bernstorff, W., Diedrich, S., Heidecke, C.D., Patrzyk, M., 2010. Laparoscopic appendectomy using a single polymeric clip to close the appendicular stump. Langenbecks Arch. Surg. 395(8), 1077-1082.
  • 19. Rickert, A., Bönninghoff, R., Post, S., Walz, M., Runkel, N., Kienle, P., 2012. Appendix stump closure with titanium clips in laparoscopic appendectomy. Langenbecks Arch. Surg. 397(2), 327-331.
  • 20. Sabbagh, C., Cosse, C., Dupont, H., Ntouba, A., Lion, T., Regimbeau, J.M., 2014. Ambulatory management of gastrointestinal emergencies: what are the current literature data? J. Visc. Surg. 151(1), 23-27.
  • 21. Sahm, M., Kube, R., Schmidt, S., Ritter, C., Pross, M., Lippert, H., 2011. Current analysis of endoloops in appendiceal stump closure. Surg. Endosc. 25(1), 124-129.
  • 22. Sajid, M.S., Rimple, J., Cheek, E., Baig, M.K., 2009. Use of endo-GIA versus endo-loop for securing the appendicular stump in laparoscopic appendicectomy: a systematic review. Surg. Laparosc. Endosc. Percutan. Tech. 19(1), 11-15.
  • 23. Sammalkorpi, H.E., Mentula, P., Leppäniemi, A., 2014. A new adult appendicitis score improves diagnostic accuracy of acute appendicitis--a prospective study. BMC Gastroenterol. 14, 114.
  • 24. Sauerland, S., Jaschinski, T., Neugebauer, E.A., 2010. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst. Rev. 10, CD001546.
  • 25. Semm, K.,1983. Endoscopic appendectomy. Endoscopy. 15(2), 59-64.
  • 26. Shaikh, F.M., Bajwa, R., Mcdonnell, C.O., 2015. Management of appendiceal stump in laparoscopic appendectomy--clips or ligature: a systematic review and meta-analysis. J. Laparoendosc. Adv. Surg. Tech. A. 25(1), 21-27.
  • 27. Shalaby, R., Arnos, A., Desoky, A., Samaha, A.H., 2001. Laparoscopic appendectomy in children: evaluation of different techniques. Surg. Laparosc. Endosc. Percutan. Tech. 11(1), 22-27.
  • 28. Simforoosh, N., Sarhangnejad, R., Basiri, A., Ziaee, S.A., Sharifiaghdas, F., Tabibi, A., Nouralizadeh, A., Kashi, A.H., Moosanejad, N., 2012. Vascular clips are safe and a great cost-effective technique for arterial and venous control in laparoscopic nephrectomy: single-center experience with 1834 laparoscopic nephrectomies. J. Endourol. 26(8), 1009-1012.
  • 29. Soll, C., Wyss, P., Gelpke, H., Raptis, D.A., Breitenstein, S., 2016. Appendiceal stump closure using polymeric clips reduces intra-abdominal abscesses. Langenbecks Arch. Surg. 401(5), 661-666.
  • 30. Wagner, M., Aronsky, D., Tschudi, J., Metzger, A., Klaiber, C., 1996. Laparoscopic stapler appendectomy. A prospective study of 267 consecutive cases. Surg. Endosc. 10(9), 895-899.
There are 30 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Clinical Research
Authors

Tuğrul Kesicioğlu 0000-0002-9263-5032

İsmail Aydın 0000-0002-9177-6298

Selahattin Vural 0000-0003-1706-3799

Early Pub Date March 18, 2022
Publication Date March 18, 2022
Submission Date November 23, 2021
Acceptance Date January 17, 2022
Published in Issue Year 2022 Volume: 39 Issue: 2

Cite

APA Kesicioğlu, T., Aydın, İ., & Vural, S. (2022). Appendiceal stump closure with hem-o-lok clips in laparoscopic appendectomy. Journal of Experimental and Clinical Medicine, 39(2), 459-462.
AMA Kesicioğlu T, Aydın İ, Vural S. Appendiceal stump closure with hem-o-lok clips in laparoscopic appendectomy. J. Exp. Clin. Med. March 2022;39(2):459-462.
Chicago Kesicioğlu, Tuğrul, İsmail Aydın, and Selahattin Vural. “Appendiceal Stump Closure With Hem-O-Lok Clips in Laparoscopic Appendectomy”. Journal of Experimental and Clinical Medicine 39, no. 2 (March 2022): 459-62.
EndNote Kesicioğlu T, Aydın İ, Vural S (March 1, 2022) Appendiceal stump closure with hem-o-lok clips in laparoscopic appendectomy. Journal of Experimental and Clinical Medicine 39 2 459–462.
IEEE T. Kesicioğlu, İ. Aydın, and S. Vural, “Appendiceal stump closure with hem-o-lok clips in laparoscopic appendectomy”, J. Exp. Clin. Med., vol. 39, no. 2, pp. 459–462, 2022.
ISNAD Kesicioğlu, Tuğrul et al. “Appendiceal Stump Closure With Hem-O-Lok Clips in Laparoscopic Appendectomy”. Journal of Experimental and Clinical Medicine 39/2 (March 2022), 459-462.
JAMA Kesicioğlu T, Aydın İ, Vural S. Appendiceal stump closure with hem-o-lok clips in laparoscopic appendectomy. J. Exp. Clin. Med. 2022;39:459–462.
MLA Kesicioğlu, Tuğrul et al. “Appendiceal Stump Closure With Hem-O-Lok Clips in Laparoscopic Appendectomy”. Journal of Experimental and Clinical Medicine, vol. 39, no. 2, 2022, pp. 459-62.
Vancouver Kesicioğlu T, Aydın İ, Vural S. Appendiceal stump closure with hem-o-lok clips in laparoscopic appendectomy. J. Exp. Clin. Med. 2022;39(2):459-62.