simple ligation oR ligation and puRse stRing invagination foR the tReatment of the appendiceal stump: a pRospective, Randomized tRial

headings – Appendectomy. Appendicitis. Surgical procedures, operative. Randomized controlled trial. abstRact – Background Although acute appendicitis is one of the most common surgical diseases, the best treatment of the appendicular stump has not been defined. At laparotomy for appendectomy the stump is treated preferably by ligation and burial of the stump and, in laparoscopic surgery, by simple ligation or clamping. Aim To compare two techniques for the treatment of appendicular stump in appendectomy (simple ligation vs ligation with purse making and burial) by a prospective and randomized study. Methods Between the years 2003 and 2005, 113 patients underwent laparotomy appendectomy for acute appendicitis. The appendiceal stump was treated by simple ligation in 49 cases and by ligation and burial in 64 cases. The two groups were similar in terms of average age, gender, preoperative signs and symptoms, time of disease progression and stage of appendicitis diagnosed histopathological examination. Results There was no statistically significant difference between the two groups regarding the duration of operation, complications (wound infection, wound dehiscence, abscess formation, intestinal obstruction, fistula and seroma ) or hospital stay. Conclusions Both techniques are equally safe for treatment of appendicular stump, and so, it is possible to recommend simple ligation because it is easier to be done.