Comparison of endoloop and Hem-o-lok clip for stump closure in laparoscopic appendectomy: which one is more cost-effective. A retrospective study

Abstract

We aimed to show the effect of closure of the appendix stump with different methods during laparoscopic appendectomy (LA), on postoperative complications, healing process and costs. Patients who underwent LA due to acute appendicitis in the last 5 years in Rize were retrospectively analyzed. Our study includes comparative analysis on two patient groups in which we carried LA. We used endoloop (EL) in Group 1 and hem-o-lok polymeric clip (HC) in Group 2 to close the appendix stump. Patients were compared in terms of demographic characteristics, American Society of Anesthesiologists (ASA) score, preoperative white blood cell and C-reactive protein (CRP) elevation, whether a drain was used, appendix diameter, pathological diagnosis, postoperative complications, duration of surgery and length of stay, and cost. Of 209 patients, 111 (51.2%) were male and 98 (48.8%) were female. The frequency of drain placement was higher in Group 2 (P = 0.005). No stump leakage was observed in either group, but the incidence of other postoperative complications was significantly higher in the EL group (P=0.041). The use of HC is cheaper than the use of EL. There was no significant difference in other parameters. Both EL and HC are used safely in LA. Although both methods do not have obvious advantages over each other, HC stands out one step further due to its more affordable cost and less possibility of postoperative complications.