Laparoscopic Appendectomy, Stump Closure and Endoloops: A Meta-Analysis

BACKGROUND Acute appendicitis（AA） is one of the main indications for urgent surgery. Laparoscopic appendectomy（LA） has shown advantages in terms of clinical results and cost-effectiveness, even if there is still controversy about different devices to utilize, especially with regards to the endoloop（EL） vs endostapler（ES） when it comes to stump closure.AIM To compare safety and cost-effectiveness of EL vs ES.METHODS From a prospectively maintained database, data of 996 consecutive patients treated by LA with a 3 years-follow up in the department of Emergency General Surgery-St Orsola University Hospital, Bologna（Italy） were retrieved. A metaanalysis was performed in terms of surgical complications, in comparison to the international literature published from 1995 to 2021.RESULTS The meta-analysis showed no evidence regarding wound infections, abdominal abscesses, and total post-operative complications, in terms of superiority of a surgical technique for the stump closure in LA.CONCLUSION Even when AA is complicated, the routine use of EL is safe in most patients.