Key result
Simple ligation during open appendicectomy significantly reduced operative time (WMD 8.72; 95% CI 6.87-10.56; P<0.00001) and postoperative ileus compared to stump invagination.
Why the study?
Does simple ligation improve clinical outcomes compared to stump invagination in patients undergoing open appendicectomy?
Meta-Analysis (n=2,634)
Does simple ligation improve clinical outcomes compared to stump invagination in patients undergoing open appendicectomy?
Mean Difference: 8.72 (95% CI 6.87–10.56)
p-value: p=< 0.00001
Simple ligation is superior to stump invagination during open appendicectomy, offering shorter operative times and faster recovery with fewer instances of ileus.
Supports preferring simple ligation in open appendicectomy; reinforces Level 1 meta-analytic evidence against routine stump invagination.
The aim of this meta-analysis was to compare the superiority of stump closure between stump invagination (SI) and simple ligation (SL) during open appendicectomy (OA). The literature searching was conducted in MEDLINE, EMBASE, the Cochrane Library, and http://scholar.google.com . Available data was extracted by 3 independent reviewers. The clinical outcomes were analyzed by meta-analytic software to compare the difference between 2 methods during OA. The pooled odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence intervals (95% CIs) were obtained by using fixed effect model. Eleven randomized controlled trials (RCTs) were finally included in this study involving 2634 patients. Postoperative pyrexia and infections were similar between SL and SI groups, respectively, but the former group had a shorter operative time (WMD: 8.72; 95% CI: 6.87-10.56; P < 0.00001); less incidence of postoperative ileus (WMD: 2.02; 95% CI: 1.36-3.01; P = 0.0005); and quicker postoperative recovery (WMD: 0.30; 95% CI: 0.11-0.48; P = 0.002). The above results were based on 5, 11, 4, 11, and 9 articles, respectively. The clinical results revealed that SL was significantly superior to SI. SL should be suggested during OA.
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Qian et al. (2015) conducted a meta-analysis in Open appendicectomy (n=2,634). Simple ligation vs. Stump invagination was evaluated on Operative time (WMD 8.72, 95% CI 6.87-10.56, p=< 0.00001). Simple ligation during open appendicectomy significantly reduced operative time (WMD 8.72; 95% CI 6.87-10.56; P<0.00001) and postoperative ileus compared to stump invagination.
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