Laparoscopic Clipping Versus Extracorporeal Ligation in Complicated Appendicitis Upper Egypt Overview

Not Applicable

Not yet recruiting

• Conditions: Appendicitis
• Interventions: Procedure: Laparoscopic appendectomy using extracorporeal ligation to secure the base of the appendix.; Procedure: Laparoscopic appendectomy using clipping.

• Registration Number: NCT05637554
• Lead Sponsor: Assiut University

Brief Summary

The investigators aim to compare between laparoscopic clipping and extracorporeal ligation in complicated appendicitis regarding safety, efficacy, operative time, postoperative outcome, hospital stay and complications.

Detailed Description

Appendectomy has become one of the most commonly performed emergency abdominal operations since it's description by McBurney in the 1890s. Since laparoscopic appendectomy was first described in 1983, there is an increase in the general trend towards performing this surgery using laparoscopy instead of open technique as this approach shows better pain score, lesser use of analgesics, less operative complications, better post operative recovery, less hospital stay and rapid return to normal work.

There are many methods for securing the base of the appendix, some of which are expensive others are not available or technically demanding. In this study the investigators aim to compare between extracorporeal ligation and clipping techniques regarding feasibility, safety, efficacy, operative time, postoperative outcome and complications especially in complicated appendicitis.

AS management of complicated appendicitis laparoscopically is possible, secure and can lead to a little occurrence of infectious complications, fewer post-operative pain, quick revival and improve cosmesis so the investigators will do a prospective clinical trial comparative study between two common techniques to determine the best one in management of complicated cases.

Study Timeline

• Study First Submitted: 2022-11-09
• Study First Submitted QC: 2022-12-01
• Study First Posted: 2022-12-05
• Status Verified: 2023-01
• Last Update Submitted: 2023-01-30
• Study Start: 2023-02
• Last Update Posted: 2023-02-01
• Primary Completion: 2023-12
• Study Completion: 2024-01

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

• Acute complicated appendicitis.
• Perforated appendicitis (diagnosed intraoperatively)
• Patients who will undergo laparoscopic appendectomy.

Exclusion Criteria

• Patients with straight forward appendectomy.
• Patients who are not fit for laparoscopic appendectomy.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Laparoscopic extracorporeal ligation appendectomy	Laparoscopic appendectomy using extracorporeal ligation to secure the base of the appendix.	This group will undergo laparoscopic extracorporeal ligation of the base of the appendix during laparoscopic appendectomy.
Laparoscopic clipping appendectomy	Laparoscopic appendectomy using clipping.	This group will undergo laparoscopic clipping of the base of the appendix during laparoscopic appendectomy.

Primary Outcome Measures

Name	Time	Method
Operative time	After procedure completion, an average of 1 hour.	Time of the total procedure.
Postoperative complications	Through study completion, an average of 1 year.	All patients will be observed postoperatively for occurrence of complications as leakage, pelvic abscess, wound infection

Secondary Outcome Measures

Name	Time	Method
Hospital stay	Through the patient's hospital stay, an average of 1 week.	Duration of hospital stay