Partial cecum resection using endostapler in acute complicated appendicitis with appendiceal base necrosis

Introduction
The method of stump closure is controversial in complicated patients, especially with appendix base necrosis or perforation. Aim: To evaluate the efficacy and safety of partial cecum resection technique with an endostapler in patients with appendix base necrosis or perforation.

Material and methods
Thirty-six patients who underwent laparoscopic partial cecum resection due to appendix base necrosis or perforation between 2015 and 2020 were retrospectively analyzed. In acute complicated appendicitis with appendiceal base necrosis or perforation, it was performed by laparoscopic partial cecum resection using an endostapler within a safe surgical margin. Demographic characteristics, duration of operation, days of hospital stay, and intra- and post-operative complications were evaluated.

Results
The mean age of the patients is 42.72 ±16.69, female/male ratio was 19/17 (52.8%/47.2%). No intraoperative complications developed. Mean operative time and hospital stay were 104.75 ±34.96, 4.58 ±2.82 days, respectively. Post-operative complications developed in 5 (13.7%) patients. One of them was wound infection (2.7%), 2 of them were ileus (5.5%) and 2 patients had an intraabdominal abscess (5.5%). Stapler line leak was not observed in any of the patients.

Conclusions
The use of an endostapler in laparoscopic appendectomy is a safe and effective technique in cases where appendix base necrosis, appendix perforation or severe inflammation affects the base of the cecum.