Benign GI diease,Benign diesease & IBD,Surgical technique
- Clinical outcomes of locking polymeric clip for laparoscopic appendectomy in patients with appendicitis: a retrospective comparison with loop ligature
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Seokwon Kim, Byong Ho Jeon, Sang Sik Cho, Ui Sup Shin, Sun Mi Moon
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Ann Coloproctol. 2022;38(2):160-165. Published online January 18, 2022
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DOI: https://doi.org/10.3393/ac.2021.00598.0085
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4,097
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4
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Abstract
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- Purpose
This study aimed to compare the clinical outcomes of laparoscopic appendectomy (LA) according to the method of appendiceal stump closure.
Methods
Patients who underwent LA for appendicitis between 2010 and 2020 were retrospectively reviewed. Patients were classified into locking polymeric clip (LPC) and loop ligature (LL) groups. Clinical outcomes were compared between the groups.
Results
LPC and LL were used in 188 (56.6%) and 144 patients (43.4%), respectively for appendiceal stump closure. No significant differences were observed in sex, age, comorbidities, and the severity of appendicitis between the groups. The median operative time was shorter in the LPC group than in the LL group (64.5 minutes vs. 71.5 minutes, P=0.027). The median hospital stay was longer in the LL group than in the LPC group (4 days vs. 3 days, P=0.020). Postoperative incidences of intraabdominal abscess and ileus were higher in the LL group than in the LPC group (4.2% vs. 1.1%, P=0.082 and 2.8% vs. 0%, P=0.035; respectively). The readmission rate was higher in the LL group than that in the LPC group (6.3% vs. 1.1%, P=0.012).
Conclusion
Using LPC for appendiceal stump closure during LA for appendicitis was associated with lower postoperative complication rate, shorter operative time, and shorter hospital stay compared to the use of LL. Operative time above 60 minutes and the use of LL were identified as independent risk factors for postoperative complications in LA. Therefore, LPC could be considered a more favorable closure method than LL during LA for appendicitis.
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- Fistula formation between urinary bladder and abdominal wall caused by bladder injury from surgical clips following laparoscopic appendectomy
Wei Zhou, Yong Suo, Tian-Yan Luo, Long-Gang Wang
Asian Journal of Surgery.2025; 48(6): 3926. CrossRef - Comparison of polymeric clip and endoloop in laparoscopic appendectomy: A systematic review and meta-analysis
Aashish Kumar, Muhammad Saqlain Mustafa, Muhammad Ashir Shafique, Abdul Haseeb, Hussain Sohail Rangwala, Haimath Kumar, Burhanuddin Sohail Rangwala, Adarsh Raja, Sandesh Raja, Syed Muhammad Sinaan Ali
Surgery.2024; 176(5): 1329. CrossRef - Advantages of using a polymeric clip versus an endoloop during laparoscopic appendectomy in uncomplicated appendicitis: a randomized controlled study
Kil-yong Lee, Jaeim Lee, Youn Young Park, Seong Taek Oh
World Journal of Emergency Surgery.2023;[Epub] CrossRef
Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer
- The Impact of Primary Tumor Resection on Survival in Asymptomatic Colorectal Cancer Patients With Unresectable Metastases
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Ki Yoon Doah, Ui Sup Shin, Byong Ho Jeon, Sang Sik Cho, Sun Mi Moon
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Ann Coloproctol. 2021;37(2):94-100. Published online April 30, 2021
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DOI: https://doi.org/10.3393/ac.2020.09.15.1
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4,900
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89
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16
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Abstract
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- Purpose
This study was conducted to evaluate the effectiveness of primary tumor resection (PTR) in asymptomatic colorectal cancer (CRC) patients with unresectable metastases using the inverse probability of treatment weighting (IPTW) method to minimize selection bias.
Methods
We selected 146 patients diagnosed with stage IV CRC with unresectable metastasis between 2001 and 2018 from our institutional database. In a multivariate logistic regression model using the patients’ baseline covariates associated with PTR, we applied the IPTW method based on a propensity score and performed a weighted Cox proportional regression analysis to estimate survival according to PTR.
Results
Upfront PTR was performed in 98 patients, and no significant differences in baseline factors were detected. The upweighted median survival of the PTR group was 18 months and that of the non-PTR group was 15 months (P = 0.15). After applying the IPTW, the PTR was still insignificant in the univariate Cox regression (hazard ratio [HR], 0.26; 95% confidence interval [CI], 0.5–1.21). However, in the multivariate weighted Cox regression with adjustment for other covariates, the PTR showed a significantly decreased risk of cancer-related death (HR, 0.61; 95% CI, 0.40–0.94).
Conclusion
In this study, we showed that asymptomatic CRC patients with unresectable metastases could gain a survival benefit from upfront PTR by analysis with the IPTW method. However, randomized controlled trials are mandatory.
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Citations
Citations to this article as recorded by

- A predictive model to identify optimal candidates for surgery among patients with metastatic colorectal cancer
Xiqiang Zhang, Zhaoyi Jing, Longchao Wu, Ze Tao, Dandan Lu
Frontiers in Oncology.2025;[Epub] CrossRef - Primary tumor resection for asymptomatic colorectal cancer patients with synchronous unresectable metastases: a meta-analysis of randomized controlled trials and case-matched studies
Jun Huang, Jiahao Zhou, Ping Zhang, Qingbin Wu, Ziqiang Wang
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef - Effect of primary tumor resection on survival in patients with asymptomatic unresectable metastatic colorectal cancer: a systematic review and meta-analysis
Chengren Zhang, Cong Cao, Lili Liu, Yaochun Lv, Jingjing Li, Jiyong Lu, Shuai Wang, Binbin Du, Xiongfei Yang
Expert Review of Anticancer Therapy.2023; 23(1): 107. CrossRef - The role of upfront primary tumor resection in asymptomatic patients with unresectable stage IV colorectal cancer: A systematic review and meta-analysis
Zongyu Liang, Zhiyuan Liu, Chengzhi Huang, Xin Chen, Zhaojun Zhang, Meijuan Xiang, Weixian Hu, Junjiang Wang, Xingyu Feng, Xueqing Yao
Frontiers in Surgery.2023;[Epub] CrossRef - Primary tumor resection in colorectal cancer patients with unresectable distant metastases: a minireview
Junge Bai, Ming Yang, Zheng Liu, Sergey Efetov, Cuneyt Kayaalp, Audrius Dulskas, Darcy Shaw, Xishan Wang
Frontiers in Oncology.2023;[Epub] CrossRef - Palliative primary tumor resection in minimally symptomatic (asymptomatic) patients with colorectal cancer and synchronous unresectable metastases versus chemotherapy alone: a metaanalysis
Iu. V. Alimova, Yu. A. Shelygin, E. G. Rybakov, M. V. Alekseev
Koloproktologia.2023; 22(2): 126. CrossRef - The impact of primary tumor resection for asymptomatic colorectal cancer patients with unresectable metastases: a systematic review and meta-analysis
Shuyuan Li, Liqiang Ji, Jie Huang, Ye Wang, Peng Liu, Wei Zhang, Zheng Lou
International Journal of Colorectal Disease.2023;[Epub] CrossRef - The impact of palliative primary tumor resection on overall survival in minimally symptomatic (asymptomatic) colorectal cancer and synchronous unresectable metastases vs chemotherapy only: a comparative study of outcomes
Iu. V. Alimova, S. I. Achkasov, Yu. A. Shelygin, M. V. Alekseev, V. N. Kashnikov, M. Yu. Fedyanin, M. A. Danilov, E. G. Rybakov
Koloproktologia.2023; 22(4): 10. CrossRef - Recurrence Patterns and Risk Factors after Curative Resection for Colorectal Cancer: Insights for Postoperative Surveillance Strategies
Hyo Seon Ryu, Jin Kim, Ye Ryung Park, Eun Hae Cho, Jeong Min Choo, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak
Cancers.2023; 15(24): 5791. CrossRef - Palliative primary tumor resection in minimally symptomatic patients with colorectal cancer and synchronous unresectable metastases: when is it necessary? (systematic review)
Iu. V. Alimova, Yu. A. Shelygin, E. G. Rybakov
Koloproktologia.2022; 21(3): 99. CrossRef - Surgical treatment for metastatic colorectal cancer
Eun Jung Park, Seung Hyuk Baik
Journal of the Korean Medical Association.2022; 65(9): 568. CrossRef - Recent Advance in the Surgical Treatment of Metastatic Colorectal Cancer-An English Version
Eun Jung Park, Seung Hyuk Baik
Journal of the Anus, Rectum and Colon.2022; 6(4): 213. CrossRef - Molecular analyses of peritoneal metastasis from colorectal cancer
Chang Hyun Kim
Journal of the Korean Medical Association.2022; 65(9): 586. CrossRef - Molecular Analyses in Peritoneal Metastasis from Colorectal Cancer: A Review-An English Version
Chang Hyun Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 197. CrossRef - Primary Tumor Resection in Asymptomatic Colorectal Cancer Patients With Unresectable Metastases: Can It Improve Survival?
Myong Hoon Ihn
Annals of Coloproctology.2021; 37(2): 71. CrossRef - Treatment for Peritoneal Metastasis of Patients With Colorectal Cancer
Young Jin Kim, Chang Hyun Kim
Annals of Coloproctology.2021; 37(6): 425. CrossRef