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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Laparoscopic appendectomy, stump closure and endoloops: A meta-analysis
Noemi Zorzetti, Augusto Lauro, Maria Irene Bellini, Samuele Vaccari, Barbara Dalla Via, Maurizio Cervellera, Roberto Cirocchi, Salvatore Sorrenti, Vito D’Andrea, Valeria Tonini
Noemi Zorzetti, Department of General Surgery, Ospedale Civile A Costa, Porretta Terme 40046, Italy
Noemi Zorzetti, Augusto Lauro, Maria Irene Bellini, Samuele Vaccari, Salvatore Sorrenti, Vito D’Andrea, Department of Surgical Sciences, Sapienza University, Rome 00161, Italy
Samuele Vaccari, Department of General Surgery, Ospedale di Bentivoglio, Bologna 40010, Italy
Barbara Dalla Via, Valeria Tonini, Department of Emergency Surgery, St Orsola University Hospital, Bologna 40138, Italy
Maurizio Cervellera, Department of General Surgery, Ospedale Santissima Annunziata, Taranto 74121, Italy
Roberto Cirocchi, Department of General Surgery, Ospedale di Terni, Università di Perugia, Terni 05100, Italy
Author contributions: Zorzetti L and Bellini MI wrote and revised the article; Lauro A, Dalla Via B, Cervellera M, Tonini V, Sorrenti S, Cirocchi R and D’Andrea V designed the research study; Vaccari S, Zorzetti N, Lauro A, and Bellini MI performed the research; and all authors have read and approve the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Maria Irene Bellini, MD, PhD, Assistant Professor, Senior Lecturer, Department of Surgical Sciences, Sapienza University, Viale Regina Elena, Rome 00161, Italy. mariairene.bellini@uniroma1.it
Received: April 21, 2022
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
ARTICLE HIGHLIGHTS
Research background
Laparoscopic appendectomy (LA) has shown advantages in terms of clinical results and cost-effectiveness, even if there is still controversy about which surgical device should be preferred to perform it.
Research motivation
To evaluate the safety cost-effectiveness of surgical devices in LA stump closure.
Research objectives
Incidence of wound infections, abdominal abscesses and total post-operative complications according to the Dindo-Clavien classification in LA stump closure with endoloop (EL) or endostapler.
Research methods
A meta-analysis was performed in terms of surgical complications, comparing the clinical data of the EL group (821 patients) to the international literature retrieved by Pubmed, according to the PRISMA principles.
Research results
There is no superiority of one or another technique in terms of surgical complications for LA stump closure.
Research conclusions
Routine use of EL is safe in most patients affected by acute appendectomy, even when complicated.
Research perspectives
Studies of EL performing accurate cost analysis are required, in addition to randomized controlled trials comparing this method to polymeric clips, as both techniques have been proved to have to be safe and effective with favorable outcomes.
