Transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure in adult patients

Objectives: We evaluated the clinical outcomes of transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure in adults. Methods: One-hundred-and-thirty-one consecutive adults with acute appendicitis were treated with the intention of performing transumbil...

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Autores principales:	Masashi Isetani, Satoshi Arakawa, Zenichi Morise, Norihiko Kawabe, Hidetoshi Nagata, Yukio Asano, Akihiko Horiguchi
Formato:	article
Lenguaje:	EN
Publicado:	Fujita Medical Society 2021
Materias:	transumbilical single incision laparoscopic surgery appendectomy Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/422273ad89124642a50d8af70982a5ac
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spelling	oai:doaj.org-article:422273ad89124642a50d8af70982a5ac2021-11-10T04:25:55ZTransumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure in adult patients10.20407/fmj.2020-0092189-72472189-7255https://doaj.org/article/422273ad89124642a50d8af70982a5ac2021-11-01T00:00:00Zhttps://www.jstage.jst.go.jp/article/fmj/7/4/7_2020-009/_pdf/-char/enhttps://doaj.org/toc/2189-7247https://doaj.org/toc/2189-7255Objectives: We evaluated the clinical outcomes of transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure in adults. Methods: One-hundred-and-thirty-one consecutive adults with acute appendicitis were treated with the intention of performing transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure from July 2012 to December 2017. The procedure completion rate and outcomes were examined. To evaluate the risk factors for conversion, the background data were compared between the patients in whom the procedure was completed versus those in whom the procedure was uncompleted. Results: The procedure was completed in 113 of 131 patients (86.3%). Single-site surgery was completed in 117 patients (89.3%). The median operation time was 79 (range 30–270) minutes and median intraoperative blood loss was 10 (range 0–394) ml. Postoperative complications occurred in 17 patients (13.0%). Postoperative hospital stay was 6 (range 1–27) days. The 18 patients in whom the procedure could not be completed comprised four patients in whom the stapler was used for intraabdominal stump closure, and 14 patients who were converted to multiport laparoscopic surgery or open surgery. Multivariate analysis showed that the independent risk factors for conversion were age, preoperative abscess, and peri-appendiceal fat density. Receiver operating characteristic curve analysis showed that the cutoff value of peri-appendiceal fat density for conversion was –40.51 Hounsfield units. Conclusions: Transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure was safe in adults with acute appendicitis. The risk factors for conversion were age ≥60 years, preoperative abscess, and peri-appendiceal fat density ≥–40.51 Hounsfield units.Masashi IsetaniSatoshi ArakawaZenichi MoriseNorihiko KawabeHidetoshi NagataYukio AsanoAkihiko HoriguchiFujita Medical Societyarticletransumbilicalsingle incisionlaparoscopic surgeryappendectomyMedicine (General)R5-920ENFujita Medical Journal, Vol 7, Iss 4, Pp 111-116 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	transumbilical single incision laparoscopic surgery appendectomy Medicine (General) R5-920
spellingShingle	transumbilical single incision laparoscopic surgery appendectomy Medicine (General) R5-920 Masashi Isetani Satoshi Arakawa Zenichi Morise Norihiko Kawabe Hidetoshi Nagata Yukio Asano Akihiko Horiguchi Transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure in adult patients
description	Objectives: We evaluated the clinical outcomes of transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure in adults. Methods: One-hundred-and-thirty-one consecutive adults with acute appendicitis were treated with the intention of performing transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure from July 2012 to December 2017. The procedure completion rate and outcomes were examined. To evaluate the risk factors for conversion, the background data were compared between the patients in whom the procedure was completed versus those in whom the procedure was uncompleted. Results: The procedure was completed in 113 of 131 patients (86.3%). Single-site surgery was completed in 117 patients (89.3%). The median operation time was 79 (range 30–270) minutes and median intraoperative blood loss was 10 (range 0–394) ml. Postoperative complications occurred in 17 patients (13.0%). Postoperative hospital stay was 6 (range 1–27) days. The 18 patients in whom the procedure could not be completed comprised four patients in whom the stapler was used for intraabdominal stump closure, and 14 patients who were converted to multiport laparoscopic surgery or open surgery. Multivariate analysis showed that the independent risk factors for conversion were age, preoperative abscess, and peri-appendiceal fat density. Receiver operating characteristic curve analysis showed that the cutoff value of peri-appendiceal fat density for conversion was –40.51 Hounsfield units. Conclusions: Transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure was safe in adults with acute appendicitis. The risk factors for conversion were age ≥60 years, preoperative abscess, and peri-appendiceal fat density ≥–40.51 Hounsfield units.
format	article
author	Masashi Isetani Satoshi Arakawa Zenichi Morise Norihiko Kawabe Hidetoshi Nagata Yukio Asano Akihiko Horiguchi
author_facet	Masashi Isetani Satoshi Arakawa Zenichi Morise Norihiko Kawabe Hidetoshi Nagata Yukio Asano Akihiko Horiguchi
author_sort	Masashi Isetani
title	Transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure in adult patients
title_short	Transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure in adult patients
title_full	Transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure in adult patients
title_fullStr	Transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure in adult patients
title_full_unstemmed	Transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure in adult patients
title_sort	transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure in adult patients
publisher	Fujita Medical Society
publishDate	2021
url	https://doaj.org/article/422273ad89124642a50d8af70982a5ac
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Transumbilical single-incision laparoscopic appendectomy with extracorporeal hand-sewn stump closure in adult patients

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