Comparative analysis of suture-based and Hem-O-lok closure techniques in laparoscopic appendectomy for uncomplicated acute appendicitis: a retrospective propensity score matching study

• Published in: Techniques in coloproctology 2025, Vol.29 (1), p.10
• Main Authors: Liang, Xian-wen, Deng, Kun, Liu, Bing, Wang, Shengzhong, Pan, Tao
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal Abscess - etiology; Abdominal Abscess - prevention & control; Abdominal Surgery; Abscesses; Adult; Appendectomy; Appendectomy - adverse effects; Appendectomy - methods; Appendicitis; Appendicitis - surgery; Cohort analysis; Colorectal Surgery; Female; Gastroenterology; Humans; Laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Operative Time; Original Article; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Proctology; Propensity Score; Retrospective Studies; Surgery; Suture Techniques; Treatment Outcome
• ISSN: 1123-6337; 1128-045X; 1128-045X
• DOI: 10.1007/s10151-024-03045-8

Background The optimal method for appendix stump closure in laparoscopic appendectomy (LA) remains debated. This study aims to evaluate the impact of suture-based closure and Hem-O-lok techniques on postoperative complications following LA for uncomplicated appendicitis. Methods A retrospective analysis was conducted on patients with uncomplicated appendicitis treated by LA from January 2019 to December 2021. These patients were categorized into two groups: the suture-based closure group (223 cases) and the Hem-O-lok group (272 cases). Propensity score matching addressed potential discrepancies between the groups. Intraoperative and postoperative parameters of both groups were then compared. Results Post-matching, the operative duration in the suture-based group was longer than in the Hem-O-lok group (45.9 ± 9.7 min versus 42.8 ± 8.9 min, P  = 0.001). The incidence of postoperative intra-abdominal abscesses and fluid collections was significantly lower in the suture-based closure group ( P  = 0.032). Multivariate logistic regression analysis revealed that the Hem-O-lok clamp technique [odds ratio (OR) = 5.69, 95% confidence interval (CI): 1.01–64.25, P  = 0.047] was a notable risk factor for intra-abdominal abscesses and fluid collections. Conclusions The suture-based closure technique significantly reduced the incidence of postoperative intra-abdominal abscesses and fluid collections compared with the Hem-O-lok technique in patients undergoing LA for uncomplicated appendicitis.