Objective To investigate the efficacy of laparoscopic treatment of gangrenous appendicitis at the base using barbed wire for closure of the residual appendiceal stump.Methods A case-control study was conducted among 58 patients with acute gangrenous appendicitis at the base who were admitted to the Department of General Surgery at Fujian Tingzhou Hospital from January 2018 to December 2022.Based on the type of suture used for burying the residual appendiceal stump during the procedure,the patients were divided into two groups:the control group(n=28,intermittent full-thickness suture embedding of the appendiceal stump using absorbable sutures)and the observation group(n=30,continuous full-thickness suture embedding of the appendiceal stump using barbed sutures).Intraoperative and postoperative related indicators,as well as the incidence of postoperative complications,were compared between the two groups.Results In the observation group,the time for closure of the residual stump was(4.17±0.66)minutes,which was significantly shorter than that in the control group(t=10.98,P＜0.001).The rate of conversion rate to open surgery in the observation group was significantly lower than that in the control group[3.33％(1/30)vs.21.42％(6/28),x2=15.13,P＜0.001].The recovery time of gastrointestinal function and the length of hospital stay in the observation group were(39.40±8.10)hours and(4.33±0.80)days,respectively,which were significantly shorter than those in the control group[(65.70±11.30)hours,(6.11±1.13)days,t=10.26,6.92,both P＜0.001].Conclusion The use of barbed wire sutures for burying the appendiceal stump in laparoscopic surgery for gangrenous/perforated appendicitis at the base effectively shortens the closure time of the stump,reduces the conversion rate to open surgery,minimizes postoperative complications,and shortens the length of hospital stay,making it a valuable technique for promotion in primary care hospitals.
AppendicitisLaparoscopyAppendectomyConversion to open surgeryOperative timeLength of stayPostoperative complications
维普
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