A prospective, randomized clinical trial

Background: Inadequate closure of the appendix stump can lead to abscess formation or peritonitis. This prospective randomized clinical trial was performed to evaluate the number of endoloops needed in laparoscopic appendectomy. Methods: A total of 208 patients were randomized in two groups: 109 in group 1 using one and 99 in group 2 using two proximal endoloops. The groups were compared in terms of intra- and postoperative complications. Results: Postoperative complications were found in five patients (4.6%) in group 1, consisting of intraabdominal abscesses (three patients), pulmonary embolism (one patient), and persisting port-site pain (one patient). In group 2, postoperative complications were found in five patients (5.1%), consisting of intraabdominal abscesses (four patients) and prolonged percutaneous drainage (one patient). There was no significant difference between the two groups. Discussion: In acute appendicitis, a minimal inflamed appendix base can be safely divided using one endoloop.