Comparative Study between Intracorporeal and Extracorporeal Sliding-Knot in Ligation of the Base of the Appendix in Laparoscopic Appendectomy

Abstract
Background: Suture ligation of appendix base during laparoscopic appendectomy with Extracorporeal Sliding-Knot (ECK) is associated with better outcomes than Intracorporeal Knot (ICK) continues to be a matter of debate.
Aim of the Study: Is to compare Extracorporeal Sliding-knot (ECK) and Intracorporeal Knot (ICK) in ligation of the base of the appendix in laparoscopic appendectomy.
Patients and Methods: This prospective randomized comparative study was carried out in Gastrointestinal, Liver & Laparoscopic Surgery Unit of Tanta University Hospitals from May 2016 till May 2017 on 30 patients with acute appendicitis divided into two equal groups; Group I: Were subjected to extracorporeal sliding-knot (15 cases) and Group II: Were subjected to intracorporeal knot (15 cases).
Results: The mean age of ECK group was 29±5.10 years, compared to 29.33±5.39 in ICK group. There were 9 males and 6 females in ECK group, compared to 7 males and 8 females in ICK group. A highly statistically significant differ-ence was present in operative time between both groups; ECK Group had operative time mean of 46.07±11.70 minutes, compared to 61.73±11.33 minutes in ICK group. Superficial wound infection developed in one patient in ECK group and two patients in ICK group. Only one patient in ICK group developed post-operative abscess in the RIF.
Conclusion: ECK technique had significant shorter oper-ative time in comparison with ICK that needs more laparo-scopic skills. Incidence of post-operative wound infection, intraabdominal abscess were higher in ICK technique, but these findings were not statistically significant.