Abstract

Comparing the complications of purse-string and simple ligation of appendix stump in appendectomy: A randomized clinical trial

Appendectomy is one of the most prevalent emergency surgeries in the world. In the present research, the consequences of closing off stump appendicitis via simple ligation versus purse-string were compared and contrasted. In the present randomized clinical trial, 140 patients had an appendectomy surgery in Shahid Mohammadi Hospital of Bandar Abbas between 2014 and 2015. Subjects were selected based on the convenient sampling method. In accordance with the inclusion and exclusion criteria as well as the tabular output of Random Allocation software, the subjects were randomly divided into two groups. In one group, 70 subjects underwent the purse-string technique (Group 1) and in the other group, 70 patients experienced the simple ligation technique (Group 2). The following information was recorded over a two-month and a one-year follow-up: surgical site infection (SSI), abdominal abscess, non-healing surgical wounds, fecal fistula, bowel obstruction, ileus, duration of operation, and duration of hospitalization. The data entered SPSS (version 19) and were analyzed through t-test, Man-Whitney U-test, Chi-squared test and Fisher’s exact test. Level of significance was set at p≤0.05. The mean age of subjects in groups 1 and 2 were 26.21±8.13 and 27.14±10 years, respectively. In the intervention group, there was 4.3% of SSI, while in the control group this rate was 2.9%. 8.6% of patients in group 1 got afflicted with postsurgery ileus. In group 2, 1.4% of patients suffered from this problem. The mean duration of hospitalization was 1.40±0.79 and 1.41±0.71 days for group 1 and group 2, respectively. This difference between the two groups was not statistically significant (P=0.596). No instance of abdominal abscess, bowel obstruction and fecal fistula was observed in the two groups. No statistically significant difference was found between the two groups in terms of the type of surgery. Due to the fact that simple ligation takes shorter time to proceed, as compared to the purse-string technique, it can be considered as the preferred technique.

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