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Advantages of using a polymeric clip versus an endoloop during laparoscopic appendectomy in uncomplicated appendicitis: a randomized controlled study
World Journal of Emergency Surgery ( IF 8 ) Pub Date : 2023-06-29 , DOI: 10.1186/s13017-023-00507-6
Kil-Yong Lee 1 , Jaeim Lee 1 , Youn Young Park 2 , Seong Taek Oh 1
Affiliation  

Polymeric clips are easy to apply, but whether they present more advantages than endoloops is unclear. This single-center, open-label, randomized controlled trial study was conducted to compare the advantages of using a polymeric clip versus an endoloop in terms of the surgical time. Adult patients who were diagnosed with acute appendicitis without perforation on preoperative abdominal computed tomography and underwent laparoscopic appendectomy between August 6, 2019, and December 26, 2022, were included. Single-blinded randomization was performed in a 1:1 ratio between the endoloop and polymeric clip groups. The primary endpoint was the difference in surgery time between the polymeric clip and endoloop groups. The secondary endpoints were the difference in the application time of each instrument, difference in operation and anesthesia fees, as well as the frequency of complications. The completed trial included 104 and 103 patients in the polymeric clip and endoloop groups, respectively. The median surgery time with a polymeric clip was shorter than that with an endoloop; however, the difference was not significant (18 min 56 s vs 19 min 49 s, p = 0.426). Interestingly, the median time from applying the instrument to appendiceal cutting in the polymeric clip group was significantly shorter than that in the endoloop group (49.0 s vs 84.5 s, p < 0.001). No significant difference was observed between the two groups in terms of surgical (p = 0.120) and anesthetic (p = 0.719) costs, as well as the total number of postoperative complications (p > 0.999). A polymeric clip is a safe instrument that can reduce the time from applying the instrument to appendiceal cutting, although it does not affect the overall surgical time and operation fee when performing laparoscopic appendectomy for uncomplicated appendicitis. Trial registration: KCT0004154.

中文翻译:

在单纯性阑尾炎腹腔镜阑尾切除术中使用聚合物夹与内环的优点:一项随机对照研究

聚合物夹很容易使用,但它们是否比内环具有更多优势尚不清楚。这项单中心、开放标签、随机对照试验研究的目的是比较使用聚合物夹与内环在手术时间方面的优势。纳入2019年8月6日至2022年12月26日期间经术前腹部计算机断层扫描诊断为急性阑尾炎但无穿孔并接受腹腔镜阑尾切除术的成年患者。内环组和聚合物夹组之间以 1:1 的比例进行单盲随机化。主要终点是聚合物夹组和内环组之间手术时间的差异。次要终点是每种器械的使用时间差异、手术和麻醉费用差异以及并发症发生频率。已完成的试验包括聚合物夹组和内环组分别有 104 名和 103 名患者。使用聚合物夹的中位手术时间比使用内环的手术时间短;然而,差异并不显着(18 分 56 秒 vs 19 分 49 秒,p = 0.426)。有趣的是,聚合物夹组中从应用器械到阑尾切割的中位时间明显短于内环组(49.0 s vs 84.5 s,p < 0.001)。两组之间在手术费用(p = 0.120)和麻醉费用(p = 0.719)以及术后并发症总数(p > 0.999)方面没有观察到显着差异。聚合物夹是一种安全的器械,可以减少从使用器械到阑尾切割的时间,但在对单纯性阑尾炎进行腹腔镜阑尾切除术时,它不会影响整体手术时间和手术费用。试用注册:KCT0004154。
更新日期:2023-06-30
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