Intracorporeal knot-tying versus metal indoclips for appendiceal stump closure in laparoscopic appendectomy : a metaanalysis

Publication Date

2014

Document Type

Research

Abstract

The appendiceal stump closure is a vital step in laparoscopic appendectomy. Poor performance of this step may result in appendiceal stump blowout that can cause tremendous morbidity and mortality. In the Philippines, cost-effectiveness of securing the stump is achieved through intracorporeal knot tying or application of metal endoclips. However, intracorporeal knot-tying is more technically challenging over endoclip application. Balancing cost-effectiveness and safety is of paramount importance. Searched for all randomized controlled trials comparing endoclip application versus intracorporeal knot-tying in databases from 1983 to December 2013, included are Cochrane Library, MEDLINE (PubMed), EMBASE, LILACS as well as WHO clinical trials platform and clinicaltrials.gov. Outcome measures intraoperative complications, postoperative complications, operative time and length of hospital stay. The study concluded that there is no conclusive evidence to prove whether there is significant difference between the use of metallic endoclip and intracorporeal knot tying for appendiceal stump closure in terms in intraoperative and postoperative complications, as well as the length of hospital stay. However, the use of metallic endoclips resulted in a shorter operative time as compared to intracorporeal knot-tying.

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