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Saeed Mahmood¹, Muhammad Kareem Ullah¹, Shahzad Naveed Jawaid², Sobia Akbar⁴, Ali Tariq¹, Mamoona Sarwar³

ABSTRACT

Objective: To explore the significant difference between metallic endo- clips and extracorporeal knot (Roeder's knot) majorly in terms of infection risks, hospital stay, operative time, and cost.

Study Design: A randomized control trial study

Place and Duration of Study: This study was conducted at the Department of Surgical Unit, Lahore General Hospital Lahore from 9^th May 2020 to 9^th May 2021.

Materials and Methods: After passing through inclusion and exclusion criteria, the patients were randomly categorized into two groups: Group A comprised of patients operated with metallic endo-clip technique and Group B was the extracorporeal knotting group. Following the surgeries in both groups, the data including demographics, hospital stay, surgery duration, overall cost, and postoperative complications were collected. SPSS 19 was used for statistical analysis and a P-value less than 0.05 for any variable was considered statistically significant.

Results: A total of 60 parties were categorized such that 32 (53.3%) were placed in group A and 28 (46.6%) in group B. The two groups didn't show a significant difference in terms of patients' age and their hospital stay (p>0.05). However, the mean surgical time for group A was shorter when group B (39 vs 41 mins, p=0.03). Moreover, extracorporeal knotting was economical (280 PKR) as compared to endo-clips (900 PKR). Among postoperative complications, the incidence rate of bleeding, postoperative ileus, intra-abdominal infection, and readmission rate was significantly higher in an endo-clip group.

Conclusion: Although, the use of endo-clips saves operative time but is costly as compared to extracorporeal knotting. The higher rate of complications reported in the former group is perceived as independent of the technique used. Therefore, both of the groups can be considered equally safe. However, given the simplicity of technique, we recommend the use of metallic endo-clips for beginners.

Key Words: Laparoscopic appendectomy, extracorporeal knotting, metallic endo-clips, appendix base closure, acute appendicitis.

Citation of article: Mahmood S, Kareem Ullah M, Jawaid SN, Akbar S, Tariq A, Sarwar M. Comparison of Extracorporeal Knot Tying Versus Metallic Endo-Clip in Laparoscopic Appendiceal Stump Closure in Patients with Uncomplicated, Acute Appendicitis. Med Forum 2021;32(12):147-151