Absorbable polymeric surgical clips for appendicular stump closure: A randomized control trial of laparoscopic appendectomy with lapro-clips

// Bo Lv 1, * , Xin Zhang 1, * , Jun Li 1, 2 , Shusheng Leng 1 , Shuqiang Li 1 , Yunlong Zeng 1 , Bing Wang 1 , Jiatian Yuan 1 , Jun Fan 1 , Shasha Xing 2 , Ci Li 3 1 General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, 610081, P.R. China 2 Central Laboratory, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, 610081, P.R. China 3 Pathology Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, 610081, P.R. China * These authors contributed equally to this work Correspondence to: Jun Li, email: junl_paper@sina.com Keywords: absorbable clip, appendicitis, appendix stump closure, laparoscopic appendectomy Received: October 30, 2015      Accepted: April 22, 2016      Published: May 11, 2016 ABSTRACT A randomized control trial was performed to evaluate the effectiveness and safety of absorbable polymeric clips for appendicular stump closure in laparoscopic appendectomy (LA). Patients were randomly enrolled into an experimental group (ligation of the appendicular base with Lapro-Clips, L-C group) or control group (ligation of the appendicular base with Hem-o-lok Clips, H-C group). We identified 1,100 patients who underwent LA between April 1, 2012 and February 3, 2015. Overall, 99 patients (9.0%, 99/1,100) developed a complication following LA (47 [8.5%] in the L-C group and 52 [9.5%] in the H-C group ( P = 0.598). No statistically significant differences were observed in intra-abdominal abscesses, stump leakage, superficial wound infections, post-operative abdominal pain, overall adverse events, or the duration of the operations and hospital stays between the groups (all p > 0.05). Adverse risk factors associated with the use of absorbable clips in LA included body mass index ≥ 27.5 kg/m 2 , diabetes, American Society of Anesthesiologists degree ≥ III, gangrenous appendicitis, severe inflammation of the appendix base, appendix perforation, and the absence of peritoneal drainage. The results indicate that the Lapro-Clip is a safe and effective device for closing the appendicular stump in LA in select patients with appendicitis.