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Randomized Controlled Trial
. 2024 Mar 8;409(1):89.
doi: 10.1007/s00423-024-03281-4.

Single versus double Hem-o-lok clips to secure the apendiceal stump during laparoscopic appendectomy: a prospective randomized multicentric clinical trial

Ulaş Aday  1 , Erman Çetin  2 , Mehmet Tolga Kafadar  3 , Abdullah Oğuz  3 , Mehmet Veysi Bahadır  3 , Burak Veli Ülger  3 , Ercan Gedik  3 , Sadullah Girgin  3 , Mehmet Yılmaz  3
Affiliations
Randomized Controlled Trial

Single versus double Hem-o-lok clips to secure the apendiceal stump during laparoscopic appendectomy: a prospective randomized multicentric clinical trial

Ulaş Aday et al. Langenbecks Arch Surg. .

Abstract

Purpose: Polymeric clips (Hem-o-lok ligation system) are now widely used to securing the base of the appendix during laparoscopic appendectomy. Studies comparing the use of single or double hem-o-lok clips are limited. The aim of this study was to compare the reliability of a single hem-o-lok clips with a double hem-o-lok clips for closure of an appendiceal stump.

Methods: This prospective randomized study includes patients from two centers who underwent laparoscopic appendectomy with the diagnosis of appendicitis between September 2020 and March 2023. Demographic, operative and clinical outcomes of the use of single or double hem-o-lok clips for closure of the appendiceal stump were compared. Factors affecting long postoperative hospital stay were investigated using univariate and multivariate analyzes.

Results: One hundred forty two (48.3%) patients in the single hem-o-lok arm and 152 (51.7%) patients in the double hem-o-lok arm were included in the analysis.The shortest operative time was noted in the single hem-o-lok group (52.1 ± 19.9 versus 61.6 ± 24.9 min, p < 0.001). The median hospital stay was 1 day (range 1-10) in the single hem-o-lok group and 1 day (range 1-12) in the double hem-o-lok group, and was shorter in the single hem-o-lok arm (1.61 ± 1.56 vs 1.84 ± 1.69, p = 0.019). Based on multivariate analysis, drain placement was identified as an independent predictive factor for long hospital stay.

Conclusions: The use of single hem-o-lok clips for appendiceal stump closure during laparoscopic appendectomy is safe and effective. Trial registration NCT04387370 ( http://www.

Clinicaltrials: gov ).

Keywords: Apendiceal stump closure; Hem-o-lok clips; Laparoscopic appendectomy; Single clips.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the study
Fig. 2
Fig. 2
Intraoperative steps of single hem-o-lok clips application
Fig. 3
Fig. 3
Intraoperative steps of double hem-o-lok clips application
See this image and copyright information in PMC

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