Endoloop Versus Endostapler Techniques in Appendicular Stump Closure during Laparoscopic Appendectomy: A Prospective Randomized Trial

Background: There has been an ongoing debate regarding the ideal method of appendicular stump closure during laparoscopic appendectomy. Objective: We conducted this study to compare endoloops and endostaplers as stump closure methods regarding postoperative infectious complications. Patients and methods: This prospective study included 110 patients diagnosed with appendicitis and scheduled for laparoscopic appendectomy. According to the stump closure method, they were divided into Group A or the endoloops group and Group B or the endostapler group. All cases received the same standard perioperative care. Preoperative, intraoperative, and postoperative data were collected, and the incidence of postoperative intraabdominal abscess was our primary outcome.
Results: Both groups showed statistically comparable findings regarding most of the demographic, clinical, and laboratory variables. Complicated appendicitis was detected in 29.09% and 36.36% of patients in groups A and B, respectively. Operative time was also comparable between the two groups (50 and 55 minutes, respectively). An intraabdominal abscess was detected in only one patient in group A (1.82%). Wound infection was encountered in two patients in each group (3.64%). The incidence of infectious postoperative complications was statistically comparable between the two groups. No need for reoperations and no port-site hernias were detected in our study.
Conclusion: Both endoloops and endostaplers have comparable intraoperative and postoperative outcomes. The surgeon should use the method he is more experienced with and according to the available facilities.