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In this randomized control trial the patients with acute appendicitis will be divided in three groups according to the management of the appendiceal stump(Endostapler, Endoloop or Endoclip). Pre-, peri- and postoperative data will be analysed.
Acute appendicitis is the most common indication for intraabdominal emergency surgery, and appendectomy is one of the most commonly performed procedures in abdominal surgery. Today laparoscopic appendectomy (LA) has the status of a ''Gold Standard'' treatment, and it is accepted as the treatment of choice for acute appendicitis.There are several ways of closing the appendiceal stump.An inadequate closure of the appendiceal stump can lead to morbidity of operated patients. The aim of this study is to assess the efficiency of different closure techniques by focusing on the intraoperative and postoperative complications.The patients will be divided into three groups based on the technique used for appendiceal stump closure, whether it is Endoloop, Endostapler or Endoclip. In the patients included in the study the investigators will analyse demographic data, peroperative laboratory values, clinical data and treatment outcomes. Also, the histopathological findings of the specimens and perioperative and postoperative complications will be analysed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Endoloop | Active Comparator | Patients in which appendiceal stump was ligated using Endoloop |
|
| Endostapler | Active Comparator | Patients in which appendiceal stump was ligated using Endostapler |
|
| Endoclip | Active Comparator | Patients in which appendiceal stump was ligated using Endoclip |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Technique used for closing the appendiceal stump | Device | In all patients, laparoscopic appendectomy is performed, only difference is the way of managing appendiceal stump |
|
| Measure | Description | Time Frame |
|---|---|---|
| Operative and postoperative complications | Number of all complications will be presented in total numbers. | Seven postoperative days |
| Operative and postoperative complications | Complications will be presented as a percentage of the all operated patients. | Seven postoperative days |
| Measure | Description | Time Frame |
|---|---|---|
| Value levels of leukocytes | Whit blood cells count | Before surgery |
| Duration of symptoms | Duration of symptoms will be measured in hours. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UH Dubrava | Zagreb | 10000 | Croatia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23025946 | Background | Yaghoubian A, Kaji AH, Lee SL. Laparoscopic versus open appendectomy: outcomes analysis. Am Surg. 2012 Oct;78(10):1083-6. | |
| 23386160 | Background | Rashid A, Nazir S, Kakroo SM, Chalkoo MA, Razvi SA, Wani AA. Laparoscopic interval appendectomy versus open interval appendectomy: a prospective randomized controlled trial. Surg Laparosc Endosc Percutan Tech. 2013 Feb;23(1):93-6. doi: 10.1097/SLE.0b013e318277df6a. |
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| ID | Term |
|---|---|
| D001064 | Appendicitis |
| ID | Term |
|---|---|
| D059413 | Intraabdominal Infections |
| D007239 | Infections |
| D005759 | Gastroenteritis |
| D005767 | Gastrointestinal Diseases |
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|
| Before surgery |
| Height | Meters | Before surgery |
| Weight | Kilograms | Before surgery |
| C-reactive protein | Milligrams/liter | Before surgery |
| Neutrophiles | Neutrophile count | Before surgery |
| Body mass index | Kilograms/meter square | Before surgery |
| Body temperature | Body temperature will be measured in degrees celsius. | Before surgery |
| Length of the operations | Length of the operations will be presented in minutes. | During operation |
| Closure of the appendiceal stump using Endoloop | Number of patients in which this technique was performed. | During operation |
| Closure of the appendiceal stump using Endoloop | Percentage of the all operated patients in which this technique was used. | During operation |
| Closure of the appendiceal stump using Endostapler | Number of patients in which this technique was performed | During operation |
| Closure of the appendiceal stump using Endostapler | Percentage of the all operated patients in which this technique was used. | During operation |
| Closure of the appendiceal stump using Endoclip | Number of patients in which this technique was performed | During operation |
| Closure of the appendiceal stump using Endoclip | Percentage of the all operated patients in which this technique was used. | During operation |
| Number of reoperated patients | Presented in total numbers | Seven days |
| Hospital stay | Length of the hospital stay will be presented in days. | Seven days |
| Histopathological findings | Histopathological findings will be graduated in 3 grades - phlegmonous,gangrenous and perforated. | Seven days |
| Percentage of reoperated patients | Presented in percentages | Seven days |
| 15026904 | Background | Beldi G, Muggli K, Helbling C, Schlumpf R. Laparoscopic appendectomy using endoloops: a prospective, randomized clinical trial. Surg Endosc. 2004 May;18(5):749-50. doi: 10.1007/s00464-003-9156-z. Epub 2004 Mar 19. |
| 16862615 | Background | Beldi G, Vorburger SA, Bruegger LE, Kocher T, Inderbitzin D, Candinas D. Analysis of stapling versus endoloops in appendiceal stump closure. Br J Surg. 2006 Nov;93(11):1390-3. doi: 10.1002/bjs.5474. |
| 8703146 | Background | Wagner M, Aronsky D, Tschudi J, Metzger A, Klaiber C. Laparoscopic stapler appendectomy. A prospective study of 267 consecutive cases. Surg Endosc. 1996 Sep;10(9):895-9. doi: 10.1007/s004649900192. |
| 22269300 | Background | Safavi A, Langer M, Skarsgard ED. Endoloop versus endostapler closure of the appendiceal stump in pediatric laparoscopic appendectomy. Can J Surg. 2012 Feb;55(1):37-40. doi: 10.1503/cjs.023810. |
| D004066 |
| Digestive System Diseases |
| D002429 | Cecal Diseases |
| D007410 | Intestinal Diseases |