[Laparoscopic cecal wedge resection].

INTRODUCTION

Several indications of cecal wedge resection can be found in the literature, but the most common ones are acute appendicitis, appendiceal mucocele and selected cecal polyps.

PURPOSE: We summarize the indications, review the results of laparoscopic cecal wedge resections carried out in our department from 01.01.2010 till 31.12.2016. A case report is presented when cecal resection was carried out for a cecal polyp.

PATIENTS: Between 01.01.2010 and 31.12.2016, 56 patients underwent a laparoscopic cecal wedge resection. The mean age was 42 years (14-83), 28 males and 28 females. In 46 cases, the indication was complicated acute appendicitis, in 6 cases appendiceal mucocele, in the case of four patients endoscopically unresectable benign cecal polyps.

RESULTS

The average operating time was 65 minutes. For the procedure we used two 10 mm and one 5 mm port, the resection was performed by using 45 or 60 mm laparoscopic stapler. In 57.1% of the reviewed cases, abdominal drainage was applied. Conversion was necessary in the case of 3 patients (5.4%), once due to bleeding, twice due to technical problems. Surgical complications occured in 4 patients (7.1%), all of them from the complicated appendicitis group: one of grade I by Clavien-Dindo, 3 of grade III. The reoperation rate was 5.4% (3 patients): reoperation was accounted for an abdominal wall phlegmon, a pericecal abscess, and once the suspicion of abdominal abscess which was not verified. Perioperative death did not occur.