APPENDICULAR STUMP MANAGEMENT IN OPEN APPENDECTOMY: SIMPLE LIGATION VERSUS INVERSION.
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Keywords
Appendicitis, Appendectomy, Appendicular stump, Ligation, Stump invagination, Open surgery
Abstract
Background: Management of the appendicular stump in open appendectomy remains debated, with simple ligation and stump invagination being the most commonly used techniques. This study aimed to compare these two methods in terms of operative duration, complications, and hospital stay.
Methods: A prospective study was conducted over two years (November 2020–October 2022) in 256 patients undergoing open appendectomy for acute appendicitis or appendicular perforation. Patients were randomly allocated into two groups: Group A (simple ligation, n=128) and Group B (ligation with stump invagination, n = 128). Outcomes measured included operative time, intraoperative and postoperative complications, and length of hospital stay.
Results: Retrocecal appendix was the most common position (62%). Appendicular perforation occurred in 23.43% of patients. Pyrexia was observed in 21.9% of Group A and 21.8% of Group B. Wound infection occurred in 10.1% and 10.9%, while wound dehiscence was 4.7% and 0.01%, respectively. Mean operative time was significantly shorter in Group A (41.11 ± 3.26 minutes) compared to Group B (51.4 ± 3.47 minutes), whereas hospital stay was similar between groups.
Conclusion: Simple ligation of the appendicular stump is a safe, effective, and time-efficient technique in open appendectomy, with comparable complication rates to stump invagination. Stump invagination offers no significant clinical advantage and prolongs operative time.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Yassir Mehmood
Department of General Surgery, Government Medical College, Rajouri.
Umbreen Nazir
Department of Physiology, Government Medical College, Rajouri.