Abstract
Amaç
:
Akut apandisit şüphesi veya doğrulanmış hastalarda laparoskopik apandisit
ameliyatı giderek artan bir tercihtir. Bu çalışmanın amacı stapler kullanımının appendiks
güdüğünün kapatılmasındaki
etkinliğini değerlendirmektir.
Method:
Akut apandisit tanısıyla Nisan 2016- Haziran 2016 tarihleri laparoskopik
apandektomi uygulanan 24 hasta çalışmaya dahil edilmiştir. Çalışma retrospektif
olarak planlanmıştır. Her bir konunun bilgilendirilmiş onayı ve Yerel Etik
Komitesi onayı alındı. Bilgilendirilmiş onam formunu imzalayan hastalar
çalışmaya dahil edildi. İmmün baskılama, diabetes mellitus, 18
yaş altı steroid ilaçları, plastrone apandisit tanısı alan, karın cerrahisi
öyküsü olan ve makroskopik ve histopatolojik olarak kanıtlanmış negatif appendektomi
yapılan hastalar hariç tutuldu. Hastanede kalış süresi,
çalışma süresi, işe geri dönüş, geri dönüş oranı, güdük sızıntısı, yara
enfeksiyon hızı ve maliyet açısından tıbbi kayıtlar retrospektif olarak
tarandı.
Sonuç: 16 erkek ve 8 kadın olan 24 hastaya
laparoskopik apandektomi uygulandı. (ortalama
yaş 33.1 – yaş ralığı 15-65 arasıdır) 24 hastada stapler kullanılarak laparoskopik appendektomi uygulamıştır.
Ortalama hastane yatış süresi 2,8 gündür(2-6 gün aralığında). Sadece 1 hastada
postoperatif yara yeri enfeksiyonu olmuştur(%4). Dönüşüm oranı
%0 ‘dır. Appendiks güdüğünün açılması
veya abse formasyonu vuku bulmamıştır(%4). Ameliyat süresi
ortalama 13 (7-21) dakika, ilk oral gıdaya ve normal günlük aktiviteye başlama
zamanı ise sırasıyla; 16 (12-26) saat, 3.8 (3-9) gün olarak bulunmuştur.
Bunlara ek olarak mevcut maliyet 320 USD artırmıştır.
References
- Semm K Endoseopic appendectomy. Endoscopy (1983) 15:59–64.
- Beldi G, Vorburger SA, Bruegger LE, Kocher T, Inderbitzin D,Candinas D Analysis of stapling versus endoloops in appendiceal stump closure. Br J Surg 9(2006) 3:1390–1393.
- Beldi G, Muggli K, Helbling C, Schlumpf R Laparoscopic appendectomy using endoloops: a prospective, randomized clinical trial. Surg Endosc (2004) 18:749–750.
- Faiz O, Clark J, Brown T, Bottle A, Antoniou A, Farrands P,Darzi A, Aylin P Traditional and laparoscopic appendectomy in adults: outcomes in English NHS hospitals between 1996 and 2006. Ann Surg(2008) 248:800–806.
- McBurney C The incision made in the abdominal wall in case of appendicitis with a description of a new method of operating. Ann Surg (1894) 20:38–43.
- Wolfram von Bernstorff & Stephan Diedrich & Claus-Dieter Heidecke & Maciej Patrzyk Laparoscopic appendectomy using a single polymeric clip to close the appendicular stump Langenbecks Arch Surg. 2010;(10), 671-9.
- Horstmann R, Tiwisina C, Classen C, Palmes D, Gillessen A Laparoscopic versus open appendectomy: which factors influence the decision between the surgical techniques? Zentralbl Chir (2005) 130:48–54.
- Ortega AE, Hunter JG, Peters JH, Swanstrom LL, Schirmer B A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy. Laparoscopic Appendectomy Study Group. Am J Surg (1995) 169:208–212.
- Piskun G, Kozik D, Rajpal S, Shaftan G, Fogler R Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis. Surg Endosc (2001) 15:660–662.
- Hirano Y, Ishikawa N, Omura K, Inaki N, Hiranuma C, Waseda R, Watanabe G Robotic intragastric surgery: a new surgical approach for the gastric lesion. Surg Endosc (2007) 21:2112–14.
- Kazemier G, in’t Hof KH, Saad S, Bonjer HJ, Sauerland S Securing the appendiceal stump in laparoscopic appendectomy: evidence for routine stapling? Surg Endosc (2006) 20:1473–1476.
- Koch A, Marusch F, Schmidt U, Gastinger I, Lippert H Appendicitis in the last decade of the 20th century—analysis of two prospective multicenter clinical observational studies. Zentralbl Chir (2002) 127:290–296.
- Binnebosel M, Otto J, Stumpf M, Mahnken AH, Gassler N, Schumpelick V, Truong S Acute appendicitis. Modern diagnostics–surgical ultrasound. Chirurg(2009) 80:579–587.
- Katkhouda N, Mason RJ, Towfigh S, Gevorgyan A, Essani R Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Ann Surg (2005) 242:439–448.
- Partecke LI, von Bernstorff W, Karrasch A, Cziupka K, Glitsch A, Stier A, Heidecke CD, Tepel J Unexpected findings on laparoscopy for suspected acute appendicitis: a pro for laparoscopic appendectomy as the standard procedure for acute appendicitis. Langenbecks Arch Surg (2010) Nov;395(8):1069-76.
Abstract
Aim:
Laparoscopic appendectomy is increasingly accepted as the
operation of choice in patients with suspected or confirmed acute appendicitis.
The aim of the current study was to evaluate the effectiveness of appendiceal
stump closure using stapler.
Methods:
24 patients with acute appendicitis who underwent
laparoscopic appendectomy between April 2016 - June 2016 were included in the
study. It was a retrospective reviewed. Informed consent of each subject and
approval of the Local Ethics Committee was obtained. The patients who had
signed the informed consent form were
included in the study. Patients with immuno suppression, diabetes mellitus,
using steroid medications, under the age of 18, over 65 were excluded.
Additionally, cases diagnosed as plastrone appendicitis, who had history of
abdominal surgery and negative appendectomy proven macroscopically and
histopathologically were excluded.Medical records were screened retrospectively, in terms of hospitalization time, duration of
operation, return to work, rate of return, stump leak, wound infection rate and
cost.
Results: Laparoscopic appendectomy was
performed in 24 patients that is 16 males and 8 females .(mean age of 33.1
years; range of 16 to 65 years). Mean hospital stay was 2,8 days (range 2–6
days). Only one patient had post-operative wound infections (4% ). Conversion
rate was 0%. No appendiceal stump leaks or intra-abdominal abscess occurred.
Mean operative time was 13 (7-21) minute . In addition, time to the onset of
oral feeding and normal daily activity were recorded and were 16 (12-26) hours,
3.8 (3-9) days respectively . Use of stapler for closure of the appendicular
stump increased the current cost of 320$(total 940$).
References
- Semm K Endoseopic appendectomy. Endoscopy (1983) 15:59–64.
- Beldi G, Vorburger SA, Bruegger LE, Kocher T, Inderbitzin D,Candinas D Analysis of stapling versus endoloops in appendiceal stump closure. Br J Surg 9(2006) 3:1390–1393.
- Beldi G, Muggli K, Helbling C, Schlumpf R Laparoscopic appendectomy using endoloops: a prospective, randomized clinical trial. Surg Endosc (2004) 18:749–750.
- Faiz O, Clark J, Brown T, Bottle A, Antoniou A, Farrands P,Darzi A, Aylin P Traditional and laparoscopic appendectomy in adults: outcomes in English NHS hospitals between 1996 and 2006. Ann Surg(2008) 248:800–806.
- McBurney C The incision made in the abdominal wall in case of appendicitis with a description of a new method of operating. Ann Surg (1894) 20:38–43.
- Wolfram von Bernstorff & Stephan Diedrich & Claus-Dieter Heidecke & Maciej Patrzyk Laparoscopic appendectomy using a single polymeric clip to close the appendicular stump Langenbecks Arch Surg. 2010;(10), 671-9.
- Horstmann R, Tiwisina C, Classen C, Palmes D, Gillessen A Laparoscopic versus open appendectomy: which factors influence the decision between the surgical techniques? Zentralbl Chir (2005) 130:48–54.
- Ortega AE, Hunter JG, Peters JH, Swanstrom LL, Schirmer B A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy. Laparoscopic Appendectomy Study Group. Am J Surg (1995) 169:208–212.
- Piskun G, Kozik D, Rajpal S, Shaftan G, Fogler R Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis. Surg Endosc (2001) 15:660–662.
- Hirano Y, Ishikawa N, Omura K, Inaki N, Hiranuma C, Waseda R, Watanabe G Robotic intragastric surgery: a new surgical approach for the gastric lesion. Surg Endosc (2007) 21:2112–14.
- Kazemier G, in’t Hof KH, Saad S, Bonjer HJ, Sauerland S Securing the appendiceal stump in laparoscopic appendectomy: evidence for routine stapling? Surg Endosc (2006) 20:1473–1476.
- Koch A, Marusch F, Schmidt U, Gastinger I, Lippert H Appendicitis in the last decade of the 20th century—analysis of two prospective multicenter clinical observational studies. Zentralbl Chir (2002) 127:290–296.
- Binnebosel M, Otto J, Stumpf M, Mahnken AH, Gassler N, Schumpelick V, Truong S Acute appendicitis. Modern diagnostics–surgical ultrasound. Chirurg(2009) 80:579–587.
- Katkhouda N, Mason RJ, Towfigh S, Gevorgyan A, Essani R Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Ann Surg (2005) 242:439–448.
- Partecke LI, von Bernstorff W, Karrasch A, Cziupka K, Glitsch A, Stier A, Heidecke CD, Tepel J Unexpected findings on laparoscopy for suspected acute appendicitis: a pro for laparoscopic appendectomy as the standard procedure for acute appendicitis. Langenbecks Arch Surg (2010) Nov;395(8):1069-76.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original article |
| Authors | |
| Publication Date | June 1, 2018 |
| Published in Issue | Year 2018 Volume: 10 Issue: 2 |
e-ISSN: 2548-0251
The content of this site is intended for health care professionals. All the published articles are distributed under the terms of
Creative Commons Attribution Licence,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.