Comparative study between simple ligation versus invagination of appendicular stump in open appendicectomy.

Dr Raheel Hussan Naqvi; Dr Mrinal Tandon; Dr Vikrant Ram; Dr Taruna Saroch

Volume : IX, Issue : V, May - 2020

Comparative study between simple ligation versus invagination of appendicular stump in open appendicectomy.

Dr Raheel Hussan Naqvi, Dr Mrinal Tandon, Dr Vikrant Ram, Dr Taruna Saroch

Abstract :

Acute appendicitis is the most common surgical disease with a lifetime risk of 7-8 % 1. Since the first descriptions of appendicectomies , the treatment of appendicular stump has been variable. Simple ligation is preferred over invagination of stump is preferred as it is simpler , less time consuming and doesn�t alter the anatomy of cecum and is similar to stump invagination in terms of post operative complications. AIMS AND OBJECTIVES: This study is designed with the aim to compare the two techniques for treatment of appendicular stump that is simple ligation versus invagination of stump prospectively. To determine the advantages and disadvantages of each method with regard to duration of surgery , intra operative, post operative complications and hospital stay. MATERIALS AND METHODS : The present study consists of 128 patients having been operated as a case of acute appendicitis and appendicular perforation admitted in Post Graduate Department of Surgery ,GMC over a period of 1 year from Feuary 2019 to Feuary 2020. The study consisted of two groups Group A-Simple ligation of appendicular stump-64 cases. Group B- Ligation and invagination of appendicular stump-64 cases. Both groups were similar with respect to age, sex and complications. INCLUSION CRITERIA- all patients > 1 year of age with acute appendicitis and appendicular perforation. EXCLUSION CRITERIA- appendicular lump , appendicular abscess , immunocompromised patients , diabetics , pregnancy and interval appendicectomy. All patients were given same pre operative antibiotics. Duration of the procedure with time from skin incision to skin closure is noted. All the patients were given same post operative antibiotics . Their post operative complications were noted and analysed. RESULTS: In the patients in group A (n=64) the incidence of post operative complications like pyrexia , wound infection, wound dehiscence and duration of hospital stay was comparable with the patients in Group B (n=64) . However the mean duration of surgery in Group A patients was significantly lower than the duration of surgery in Group B patients . CONCLUSION:In conclusion we recommend that appendix stump should be simply ligated as it is less time consuming and is comparable with stump invagination in terms of post operative complications.