الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 98 |  |  |
| | | from | 98 | | |
Abstract
Background: Laparoscopic appendectomy is now the standard of care for cases of cute appendicitis. It has all the benefits of minimal access surgery .there are many methods for securing the base of the appendix, some of which are expensive others are not available or technically demanding. Background: Laparoscopic appendectomy is now the standard of care for cases of cute appendicitis. It has all the benefits of minimal access surgery .there are many methods for securing the base of the appendix, some of which are expensive others are not available or technically demanding. In our study we compared between intra-corporeal ligation and metallic clips application for securing the appendicular stump. Aim of the work: To compare between intra-corporeal ligation and metabolic clip application as regard safety, simplicity, competence and complications related to each technique. Patients and methods: We conducted the study in the period between December 2016 and May 2018 in Mansura university hospitals on 80 patients. 44 patients underwent intra-corporeal ligation and 36 patients underwent metallic clip application. Patients were randomly distributed into 2 groups .Failure to do one technique is considered failure and an indication to do the other. Results: The mean operative time in group A was 39 minutes and 48 minutes for group B, P value < 0.05. The mean hospital stay was 1.8 in group A and 1.9 in group B, P value > 0,05. No intra operative complications in both groups. There was failure of the technique of clip application in 4 cases (group A). No failure of the technique occurred in group B. Conclusion : Both methods of ICL and clip are cost effective in securing the appendicular stump. The only limitation of the clip application is the wide diameter of the base of the appendix which can be managed by intra-corporeal ligation. The technique of the ligation first can be applied in selected cases while the devascularization first can be done in all cases. Metal clips application is related to less operative time , easier application and simpler for trainee with no additional cost
Patients were randomly distributed into 2 groups .Failure to do one technique is considered failure and an indication to do the other. Results: The mean operative time in group A was 39 minutes and 48 minutes for group B, P value < 0.05. The mean hospital stay was 1.8 in group A and 1.9 in group B, P value > 0,05. No intra operative complications in both groups. There was failure of the technique of clip application in 4 cases (group A). No failure of the technique occurred in group B. Conclusion : Both methods of ICL and clip are cost effective in securing the appendicular stump. The only limitation of the clip application is the wide diameter of the base of the appendix which can be managed by intra-corporeal ligation. The technique of the ligation first can be applied in selected cases while the devascularization first can be done in all cases. Metal clips application is related to less operative time , easier application and simpler for trainee with no additional cost