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. 2024 Sep 5;409(1):270.
doi: 10.1007/s00423-024-03452-3.

Effectiveness of different appendiceal stump closure methods in laparoscopic appendectomy a network meta-analysis

Qasi Najah  1   2 , Hamdy A Makhlouf  3 , Mariam A Abusalah  4   5 , Menna M Aboelkhier  6   7 , Mohamed Abdalla Rashed  8   7 , Muataz Kashbour  9   2 , Sara Adel Awwad  10   11 , Fatmaelzahraa Yasser Ali  12   7 , Nada Ibrahim Hendi  13   7 , Sherein Diab  13   7 , Fatima Abdallh  14   11 , Ahmed Mohamed Abozaid  15   7 , Yasmeen Jamal Alabdallat  14   11
Affiliations

Effectiveness of different appendiceal stump closure methods in laparoscopic appendectomy a network meta-analysis

Qasi Najah et al. Langenbecks Arch Surg. .

Abstract

Purpose: Choosing the best stump closure method for laparoscopic appendectomy has been a debated issue, especially for patients with acute appendicitis. The lack of consensus in the literature and the diverse techniques available have prompted the need for a comprehensive evaluation to guide surgeons in selecting the most optimal appendiceal stump closure method.

Methods: A comprehensive search was conducted on multiple databases from inception until December 2023 to find relevant studies according to eligibility criteria. The primary outcome was the incidence of total complications.

Results: 25 studies with a total of 3308 patients were included in this study, overall complications did not reveal a significant advantage for any intervention (RR = 0.72, 95% CI: 0.53; 1.01), Superficial and deep infection risks were similar across all methods, Operative time was significantly longer with endoloop and Intracorporeal sutures (MD = 7.07, 95% CI: 3.28; 10.85) (MD = 26.1, 95% CI: 20.9; 31.29).

Conclusions: There are no significant differences in overall complications among closure methods. However, Intracorporeal sutures and endoloop techniques were associated with extended operative durations.

Keywords: Appendiceal stump; Appendicitis; Laparoscopic appendectomy; Network meta-analysis.

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