A comparative study of simple ligation and simple ligation with invagination of appendicular stump

Authors

  • Syed Rizwanuddin Qazi Department of Surgery, Dr Panjabrao Deshmukh Hospital, Amravati
  • Anil Vishwasrao Darokar Department of Surgery, Dr Panjabrao Deshmukh Hospital, Amravati
  • Varsha Nitin Bijwe Department of Surgery, Dr Panjabrao Deshmukh Hospital, Amravati
  • Rajiv Mangalmurti Mulmule Department of Surgery, Dr Panjabrao Deshmukh Hospital, Amravati
  • Kishor Krishnarao Bele Department of Surgery, Dr Panjabrao Deshmukh Hospital, Amravati

DOI:

https://doi.org/10.18203/2320-6012.ijrms20161215

Keywords:

Acute appendicitis, Appendicectomy, Appendicular stump, Simple ligation, Invagination

Abstract

Background: Acute appendicitis is the most common abdominal emergency. During open appendicectomy the best treatment of the appendicular stump has not been defined. This is a randomized control trial of simple ligation and simple ligation with invagination of appendicular stump.

Methods: The diagnosis of acute appendicitis was based on the MASS (Modified Alvardo Score System). ECG and X-Ray chest were done when needed. All the patients were operated under spinal anesthesia.

Results: Total 313 patients were operated and randomly divided into two groups, in group A appendicular stump was treated with simple ligation (n=166) and group B underwent ligation and invagination (n=147). Post-operative complications like pyrexia, vomiting, serous discharge, wound infection, peritonitis, residual abscess and post-operative pain in right iliac fossa are comparable in both the groups. Mean operating time in group A was shorter but statistically insignificant. The incidence of paralytic ileus was 3 (1.81%) and 8 (5.44%) patients in group A and group B respectively and was statistically significant.

Conclusions: During open appendicectomy simple ligation of appendicular stump is recommended as it is safe, simple and having shorter operative time.

 

References

Boswell CB, Doherty GM. Diseases of appendix. In: Doherty GM, Meko JB, Olson JA, Peplinski GR, Worrall NK, eds. The Washington Manual of Surgery. 2nd ed. Lippincott Williams & Wilkins. Philadelphia, 1999:228-35.

Malik K, Ahmad W, Channa A, Khan A, Waheed I. Epidemiology of acute appendicitis: a study of 354 cases in Jinnah postgraduate medical centre, Karachi. The J Surg PIMS. 1993;5:31-3.

Kelly HA. The appendicitis and other diseases of the vermiform appendix. Philadelphia, WB Saunders Company; 1905;502.

Kingsley DPE. Some observations on appendicectomy with particular reference to technique. Br J Surg. 1969;56:491-6.

Sinha AP. Appendicectomy: an assessment of the advisability of stump invagination. Br J Surg. 1977; 64(7):499-500.

Street D, Bodai BI, Owens LJ, Moore DB, Walton CB, Holcroft JW. Simple ligation vs. stump inversion in appendectomy. Arch Surg. 1988; 123(6):689-90.

Andrade JL, Sandoval EGB, Gomes CAP, Scarpelini S, Seneviva R. Appendicectomia: tratamento do coto apendicular por ligadura e por sepultamento. Rev Col Bras Cir. 1996;11(6):314-9.

Kruel NF, Novelletto ST, El Haje AA, Franzon O, Susuki H, Andrian AC. Estudo comparative do coto apendicular por ligadura e por sepultamento. Rev Bras Cir. 1996;86(6):293-6.

Lavonius MI, Leesjarvi S, Niskanen RO, Restkari SK, Korkala O, Mokka RE. Simple ligation vs stump inversion in appendicectomy. Ann Chir Gynaecol. 1996;85(3):222-4.

Watters DA, Walker MA, Abernethy BC. The appendix stump: should it be invaginated? Ann R Coll Surg Engl. 1984 Mar;66(2):92-3.

Jacobs PP, Koeyers GF, Bruyninckx CM. Simple ligation superior to inversion of the appendiceal stump: a prospective randomized study. Ned Tijdschr Geneeskd. 1992;136(21):1020-3.

Neves LJ, Wainstein AJ, Mathias WC, Costa FP, Castro JH, Rocha PRS. Simple ligation or ligation and purse string invagination for the treatment of the appendiceal stump: a prospective randomized trial. Arq Bras Cir Dig. 2011;24 (1):15-9.

Chalya PL, Mchembe M. Is invagination of appendicular stump in appendicectomy necessary? A prospective randomized clinical trial. East Cent Afr J Surg. 2012;17(1):85-9.

Mahzar R, Leem AM, Sarfraz A, Riaz U. Appendicectom non-invagination vs invagination of appendicular stump. Ann King Edward Med Coll. 2006;12(1):35-8.

Engstrom L, Fenyo G. Appendicectomy: assessment of stump invagination versus simple ligation: a prospective randomized trial. Br J Surg. 1985; 72(12):971-2.

Naeem S, Khalid I. Appendicectomy: non-invagination vs invagination of appendicular stump. The Professional. 2004;11(2):117-20.

Singh G, Pandey A. Management of appendix stump: The technique. Med J DY Patil Univ. 2012; 5:106-9.

Minhas Q, Siddique K, Mirza S, Malik A. Post-operative complications of stump ligation alone versus stump ligation with invagination in appendicectomy. Int J Surg. 2010;22(2).

Chaudhary IA, Samiullah, Mallhi AA, Afridi Z, Bano A. Is it necessary to invaginate the stump after appendicectomy? Pak J Med Sci. 2005;21(1):35-8.

Jacobs PP, Koeyers GF, Buryninckx CM. Simple ligation superior to inversion of the appendiceal stump: a prospective randomized study. Ned Tijdschr Geneeskd. 1992;36(21):1020-3.

Lavonius MI, Liesjarvi S, Niskanen RO, Ristkari SK, Korkala O, Mokka RE. Simple ligation vs stump inversion in appendicectomy. Ann Chir Gynaecol. 1996;85(3):222-4.

Watter DAK, Walker MA, Abernethy BC. The appendix stump: should it be invaginatied? Ann Roy Coll Surg Engl. 1984;66:92-6.

Downloads

Published

2016-12-30

How to Cite

Qazi, S. R., Darokar, A. V., Bijwe, V. N., Mulmule, R. M., & Bele, K. K. (2016). A comparative study of simple ligation and simple ligation with invagination of appendicular stump. International Journal of Research in Medical Sciences, 4(5), 1485–1489. https://doi.org/10.18203/2320-6012.ijrms20161215

Issue

Section

Original Research Articles