Use of endo-GIA versus endo-loop for securing the appendicular stump in laparoscopic appendicectomy: a systematic review.

OBJECTIVE

To systematically analyze the trials on laparoscopic appendicectomy (LA) that has evaluated the effectiveness of endo-loop and/or endo-GIA (a linear stapling device) to secure the stump of the appendix.

METHODS

Clinical trials on LA were selected from the electronic database and analyzed to generate summative data.

RESULTS

Five randomized trials on 622 patients were analyzed. In both fixed and random effect models, operative time for endo-loop group was longer than endo-GIA group. There was no difference in total hospital stay and in the incidence of intra-abdominal abscess formation between 2 groups. In the fixed effect model, endo-loop technique was associated with higher complication rate.

CONCLUSIONS

Use of endo-loop to secure the appendicular stump during LA though takes longer than the use of endo-GIA but it is associated with equal hospital stay, perioperative complication rate, and incidence of intra-abdominal abscess. Endo-loop may be used safely and preferably to secure the appendicular stump.