Published online Sep 27, 2022. doi: 10.4240/wjgs.v14.i9.1060
Peer-review started: April 21, 2022
First decision: July 14, 2022
Revised: July 22, 2022
Accepted: August 19, 2022
Article in press: August 19, 2022
Published online: September 27, 2022
Processing time: 153 Days and 18.4 Hours
Acute appendicitis (AA) is one of the main indications for urgent surgery. Laparoscopic appendectomy (LA) has shown advantages in terms of clinical results and cost-effectiveness, even if there is still controversy about different devices to utilize, especially with regards to the endoloop (EL) vs endostapler (ES) when it comes to stump closure.
To compare safety and cost-effectiveness of EL vs ES.
From a prospectively maintained database, data of 996 consecutive patients treated by LA with a 3 years-follow up in the department of Emergency General Surgery - St Orsola University Hospital, Bologna (Italy) were retrieved. A meta-analysis was performed in terms of surgical complications, in comparison to the international literature published from 1995 to 2021.
The meta-analysis showed no evidence regarding wound infections, abdominal abscesses, and total post-operative complications, in terms of superiority of a surgical technique for the stump closure in LA.
Even when AA is complicated, the routine use of EL is safe in most patients.
Core Tip: Stump closure in the acute appendectomy setting could be performed via endoloop (EL) or endostapler use. The present meta-analysis assesses the experience of 996 patients consecutively treated in the department of Emergency General Surgery - St Orsola University Hospital, Bologna (Italy) and the evidence published in literature, confirming there is no superiority of a surgical method on how to perform the stump closure, with regards to wound infections, abdominal abscess, and total post-operative complications. Even when acute appendicitis is complicated, the routine use of EL is safe in most patients.