PubMed · 5941650
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S E O'Brien. 1966. Intussusception complicating appendectomy: a case report.. https://pubmed.ncbi.nlm.nih.gov/5941650/
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We performed a meta-analysis to determine whether laparoscopic or open appendectomy gives better outcomes for patients with suspected acute appendicitis. Studies were selected from the MEDLINE database, personal files, and meeting abstracts. Eleven of 21 randomized controlled trials were included in the meta-analysis. Pooled effect size estimates were calculated using a random effects model. Laparoscopic appendectomy reduced time to full functioning by 5.48 days (95% confidence interval [CI] 3.70 to 7.26; p < 0.001), improved postoperative pain at 24 hours measured by a visual analog scale from 0 to 10 by 1.19 points (95% CI -2.14 to -0.24 points; p=0.014), and decreased the absolute risk for wound infection by 3.2% (95% CI -5.6% to -0. 8%; p=0.009). Operating time was increased by 17.12 min (95% CI 14.19 to 20.03; p < 0.0001). There was no difference between the two surgeries for length of hospital stay, readmission rate, and intra-abdominal abscess formation. Laparoscopic appendectomy improves patient outcomes.
The manipulation of the inflamed appendix during laparoscopic surgery and avoiding its disintegration or leakage can be challenging even to experts. A suture loop form through an intravenous catheter may offer the least traumatic handling of the appendix, and it serves the extra benefit of leaving no scar. Furthermore, multiple loops can be formed conveniently and economically by a single long suture material. It can also ensure snaring at the very base of the appendix. We attempted this technique in 15 patients with 14 successful operations; there was great patient satisfaction and there were no surgical complications. Difficulty was encountered only when the surgeon tried to loop the buried appendix tip that cannot be delivered by one-hand manipulation.
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