117 A Systematic Review Comparing Clinical Outcomes Between Hem-O-Lok Clips and Endoloops In Securing the Base of The Appendix During Laparoscopic Appendicectomy
Abstract Introduction One of the crucial steps of laparoscopic appendicectomy is to secure the base of appendix. A variety of techniques for stump closure have been described as Endoloops(Vicryl or PDS), Hem-o-lok clips, intracorporeal suturing and endoscopic staplers. Method A detailed literature survey using Pubmed, MEDLINE and EMBASE databases was carried out to extract studies conducted between 1990 and 2020. A total of 14 studies- 3 randomized controlled trials & 11 comparative studies enrolling 2098 (1030 in HL & 1068 in EL group) patients were included in the final analysis comparing Hem-o-lok versus endoloops for closure of appendiceal base. Outcome measures were Operative time, Cost benefit, Post-operative complications, and length of hospital stay. Results The average time of operation was significantly shorter in the HL group (SMD -0.79; 95% CI -1.03 – 0.56; z = 6.61; p < 0.00001). HL was found to be more cost-effective. (SMD -5.00; 95% CI-7.00 – 3.00; z = 4.90; p < 0.00001). However, no statistical difference was found between both the groups when comparing mean postoperative length of hospital stay & post-operative. Conclusions Based on the results of the above study, applying Hem-o-lok clips seems to be a safe, effacious and cost-effective way of securing the base of appendix.