Comparative analysis of suture-based and Hem-O-lok closure techniques in laparoscopic appendectomy for uncomplicated acute appendicitis: a retrospective propensity score matching study

BackgroundThe optimal method for appendix stump closure in laparoscopic appendectomy (LA) remains debated. This study aims to evaluate the impact of suture-based closure and Hem-O-lok techniques on postoperative complications following LA for uncomplicated appendicitis.MethodsA retrospective analysis was conducted on patients with uncomplicated appendicitis treated by LA from January 2019 to December 2021. These patients were categorized into two groups: the suture-based closure group (223 cases) and the Hem-O-lok group (272 cases). Propensity score matching addressed potential discrepancies between the groups. Intraoperative and postoperative parameters of both groups were then compared.ResultsPost-matching, the operative duration in the suture-based group was longer than in the Hem-O-lok group (45.9 +/- 9.7 min versus 42.8 +/- 8.9 min, P = 0.001). The incidence of postoperative intra-abdominal abscesses and fluid collections was significantly lower in the suture-based closure group (P = 0.032). Multivariate logistic regression analysis revealed that the Hem-O-lok clamp technique [odds ratio (OR) = 5.69, 95% confidence interval (CI): 1.01-64.25, P = 0.047] was a notable risk factor for intra-abdominal abscesses and fluid collections.ConclusionsThe suture-based closure technique significantly reduced the incidence of postoperative intra-abdominal abscesses and fluid collections compared with the Hem-O-lok technique in patients undergoing LA for uncomplicated appendicitis.