Comparison of Laparoscopic Methods of Management of Appendix Stump

INTRODUCTION: Today, laparoscopic appendectomy (LAE) is the ‘golden standard’ of the treatment for acute appendicitis. However, the choice of the method of management of the appendix stump (AS) causes much debate.

AIM: Comparative analysis of invagination and ligation methods of management of the appendix stump in LAE.

MATERIALS AND METHODS: The analysis included data from 130 patients who underwent LAE. An analysis and comparison of the invagination and ligation methods of management of AS are presented.

RESULTS: There were no significant differences in the frequency of mild postoperative complications of LAE, severity of pain syndrome and length of hospital treatment. The difference was in the time of the surgical intervention, which was longer in the group of patients with AS managed using the invagination method. The frequency of infiltrates of the right iliac fossa was lower in the group of AS management using invagination method.

CONCLUSION: This clinical study demonstrated the effectiveness, safety and availability of the invagination method of AS management compared to the ligation method. A disadvantage of the invagination method is the requirements to the surgeon’s practical skills and a significant increase in the length of the operation. The management of the AS by immersing it with the intracorporal suture into the cecum cupula can be recommended for use in the everyday surgical practice.