A Totally Laparoscopic Colectomy is Feasible for Acute Complicated Appendicitis with Necrotic Appendiceal Base in the Emergency Setting
Giulio M. Mari, Jacopo Crippa, Francesca Roufael, Richard Sassun, Emanuele Di Fratta, Angelo Miranda, Carmelo Magistro, Angelo Guttadauro, Barbara Vignati, Martino Gerosa, Mauro Santonocito, Dario Maggioni on behalf of the AIMS Academy Clinical Research NetworkOriginal article, no. 1, 2025
Article DOI: 10.21614/chirurgia.3065
Introduction: Acute appendicitis remains one of the most common surgical emergencies worldwide. Complicated acute appendicitis may present as perforated or gangrenous appendicitis with a compromised appendiceal base. This is a challenging scenario for surgeons that may require, in some cases, an ileocolic resection. This study aims to demonstrate the advantages and efficacy of a minimally invasive approach to complicated appendicitis requiring ileocolic resection.
Materials and Methods: We reviewed patients who underwent extended resection for complicated acute appendicitis at our hospital from January 2022 to May 2024. Baseline, preoperative, intraoperative and postoperative features were analyzed.
Results: During the study period, 15 patients with acute appendicitis required laparoscopic extended resection. Nine (56.2 %) underwent ileocecal resection, and 6 (43.8%) underwent right colectomy. All patients had an intracorporeal side to side, isoperistaltic 60 mm mechanical anastomosis. Mean length of stay was 7 +- 1.3 days with no CD III and IV complications. No postoperative abdominal abscesses or anastomotic leaks occurred.
Conclusions: Totally laparoscopic approach is a safe procedure for patients with complicated appendicitis requiring ileocolic resection.
Materials and Methods: We reviewed patients who underwent extended resection for complicated acute appendicitis at our hospital from January 2022 to May 2024. Baseline, preoperative, intraoperative and postoperative features were analyzed.
Results: During the study period, 15 patients with acute appendicitis required laparoscopic extended resection. Nine (56.2 %) underwent ileocecal resection, and 6 (43.8%) underwent right colectomy. All patients had an intracorporeal side to side, isoperistaltic 60 mm mechanical anastomosis. Mean length of stay was 7 +- 1.3 days with no CD III and IV complications. No postoperative abdominal abscesses or anastomotic leaks occurred.
Conclusions: Totally laparoscopic approach is a safe procedure for patients with complicated appendicitis requiring ileocolic resection.
Keywords: colorectal surgery, appendectomy, minimally invasive surgery, ileocecal resection, emergency colectomy
