Laparoscopic appendectomy in complicated appendicitis with compromised appendix base: a retrospective cohort study. 2021

Karina Flores-Marín, and Andrés Rodríguez-Parra, and Mario Trejo-Ávila, and Eduardo Cárdenas-Lailson, and Roberto Delano-Alonso, and Carlos Valenzuela-Salazar, and Jesus Herrera-Esquivel, and Mucio Moreno-Portillo
Departamento de Cirugía General y Endoscópica, Hospital General Dr. Manuel Gea González, Ciudad de México, México.

BACKGROUND Patients with compromised appendix base constitute a subgroup of patients with complicated appendicitis, and there is few available information. OBJECTIVE To study the frequency of stump leaks and fistulae in patients with complicated appendicitis with compromised stump. METHODS This is an observational, retrospective study of patients that underwent laparoscopic appendectomy with compromised appendix stump. RESULTS From 2015 to 2019, 158 patients with complicated appendicitis were operated, of them 54 had compromised base or stump. There were 66.7% men, with a mean age of 38.7 years. For stump closure, a simple knot was employed in 57.4%, and in 42.6% an invaginated suture was employed. Regarding complications, 16.7% developed intraabdominal abscess, 7.4% ileus and 7.4% had wound infection. We found one stump leak and one stump fistula. The mean length of stay was 5.4 days (range: 1-20). There were 5 reoperations, 4 for abscess drainage and 1 for stump leak. CONCLUSIONS Patients with acute complicated appendicitis with compromised appendicular base, laparoscopic surgery either with simple knot or with invaginated suture resulted in low frequency of stump leaks and fistula.

UI MeSH Term Description Entries
D008297 Male Males
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001062 Appendectomy Surgical removal of the vermiform appendix. (Dorland, 28th ed) Appendectomies
D001064 Appendicitis Acute inflammation of the APPENDIX. Acute appendicitis is classified as simple, gangrenous, or perforated. Perforated Appendicitis,Ruptured Appendicitis,Appendicitis, Perforated,Appendicitis, Ruptured
D001065 Appendix A worm-like blind tube extension from the CECUM. Vermiform Appendix,Appendix, Vermiform
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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