Evidence map›Paper›PMID 29404732›Full record

ArticleSurgical endoscopy2018

Endoloop versus endostapler: what is the best option for appendiceal stump closure in children with complicated appendicitis? Results of a multicentric international survey.

Maria Escolino, Francois Becmeur, Amulya Saxena, Holger Till, George W Holcomb, Ciro Esposito

Abstract readComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
5.1field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Acute appendicitis-advances and controversies.World journal of gastrointestinal surgery · 2021
    Review
  8. Article
  9. Article
  10. Outcomes of Open and Laparoscopic Appendectomy With Single Endoloop Stump Closure.JSLS : Journal of the Society of Laparoendoscopic Surgeons
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 4 countries.

Maria EscolinoDivision of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy.
Francois BecmeurDivision of Pediatric Surgery, Hopitaux Universitaires de Strasbourg, Strasbourg, France.
Amulya SaxenaDivision of Pediatric Surgery, Chelsea Children's Hospital, London, UK.
Holger TillDivision of Pediatric Surgery, Medical University of Graz, Graz, Austria.
George W HolcombDivision of Pediatric Surgery, Mercy Children's Hospital, Kansas City, MO, USA.
Ciro EspositoDivision of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy. ciroespo@unina.it.
University of Naples Federico II · ITChildren's Mercy Hospital · USHôpitaux Universitaires de Strasbourg · FRMedical University of Graz · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is a limited and conflicting evidence about the most appropriate method for appendiceal stump closure during laparoscopic appendectomy (LA). We aimed to compare endoloop (EL) versus endostapler (ES) for stump closure during LA for complicated perforated appendicitis in children.

methodsWe retrospectively reviewed the records of 708 patients (463 boys and 245 girls with an average age of 9.8 years) who underwent LA for complicated appendicitis in 5 international centers of Pediatric Surgery over a 5-years period (January 2011-December 2016). The appendix was perforated with localized peritonitis in 470 cases and diffuse peritonitis in 238 patients. EL was used in 374 cases (G1), whereas ES was adopted in 334 cases (G2).

resultsNo intra-operative complication occurred in both groups but 5 conversions to open surgery were reported in G1 (1.3%) and 4 in G2 (1.1%) (OR 1.1; 95% CI 0.30-4.19). Use of EL was significantly associated with higher incidence of intra-abdominal abscess (OR 1.36; 95% CI 0.84-2.18), postoperative ileus (OR 3.61; 95% CI 0.76-17.11), and re-operations/readmissions (OR 6.46; 95% CI 1.46-28.62) compared to ES. The average cost of supplies for LA was significantly higher in G2 (€ 915.60) compared to G1 (€ 578.36) (p = 0.0001). The average cost of re-operations/readmissions was significantly higher in G1 (€ 4.091,39) compared to G2 (€ 2.127,88) (p = 0.0001) (OR 1.72; 95% CI 1.47-2.01).

conclusionsOur study is the first in the pediatric population to demonstrate that the method used for appendiceal stump closure may influence the outcome of LA in complicated appendicitis. Although ES is more expensive compared to EL, our results demonstrated that appendix stump closure should be performed using ES rather than EL in complicated perforated appendicitis since its use was associated with a lower incidence of postoperative intra-abdominal abscess and postoperative ileus and lower re-operations and readmissions rates and costs.

Indexed as

Surgical StaplersAppendectomyAppendicitisChildFemaleHumansLaparoscopyMalePostoperative ComplicationsReoperationRetrospective StudiesTreatment OutcomeWound Closure TechniquesAbscessChildrenComplicated appendicitisEndoloopEndostaplerLaparoscopy

Identifiers

PMID29404732
OpenAlexW2793047434

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.