SIMPLE LIGATION VERSUS INVAGINATION OF STUMP IN OPEN APPENDICECTOMY
Keywords:
Appendix, Appendicular stump, Ligation, Invagination, appendicectomyAbstract
Objective: To compare the outcome of simple ligation versus invagination of stump in appendicitis.
Material and Methods: This descriptive study was conducted on 100 patients who underwent open appendicectomy at the department of surgery Hayatabad Medical complex Peshawar from December 2011 to October 2013. All patients presented with signs and symptoms of appendicitis that failed to respond to conservative management. The patients were divided in 2 groups. In group A odd numbered patients were included and even numbered patients were included in group B. Approach was through Grid iron incision. Simple ligation of stump was done in Group A and invagination of stump in Group B. The demographics, presenting complaints, severity of pain, operating surgeons, operating time and problems, postoperative pain and any other complications were recorded on a Performa specially designed for this purpose. Vicryle 2/0 was used for stump closure, and wound closure with vicryle 0 and skin with prolene 2/0 interrupted
sutures. All patients were given local anaethesthetic at the surgical skin wound site after conclusion of surgery. Patients were followed up to 6-8 weeks.
Results: The mean age was 21.3 years in a range of 13-65 years for both groups. Male patients 37 (74%) and female patients 13 (26%) in group A while in group B it was 34 (68%) and 16 (32%) respectively. Regarding complications wound infection occurred in 3 (6%) patients in group A and 6 (12%) patients in group B. Paralytic ileus was 1 (2%) in group A and 3 (6%) in group B. Post-operative pain was recorded using visual analogue scale (VAS). 3 patients in Group A (6%) and 5 patients (10%) in Group B developed moderate pain that required parenteral analgesia and extra duration of hospital stay. Mean hospital stay was 2.10 days among both groups with 1.96 days in group A & 2.06 days in group B patients.
Conclusion: Simple ligation in comparison with invagination of stump is simple, safer, less hazardous, less time consuming,
associated with less postoperative complications, and shorter hospital stay.
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