Nonclosure of the Peritoneum during Appendectomy May Cause Less Postoperative Pain: A Randomized, Double-Blind Study.

Huseyin Kazim Bektasoglu, Mustafa Hasbahceci, Samet Yigman, Erkan Yardimci, Enver Kunduz, Fatma Umit Malya
Author Information
  1. Huseyin Kazim Bektasoglu: Department of General Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey. ORCID
  2. Mustafa Hasbahceci: Department of General Surgery, Medical Park Fatih Hospital, Istanbul 34080, Turkey. ORCID
  3. Samet Yigman: Department of General Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey.
  4. Erkan Yardimci: Department of General Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey.
  5. Enver Kunduz: Department of General Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey. ORCID
  6. Fatma Umit Malya: Department of General Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey. ORCID

Abstract

Objective: We aim to evaluate the effect of peritoneal closure on postoperative pain and life quality associated with open appendectomy operations.
Methods: This is a single-center, prospective, randomized, and double-blinded study. Here, 18-65-year-old patients who underwent open appendectomy for acute appendicitis were included. Demographic data of the patients, operation time, length of hospital stay, pain scores using a 10 cm visual analogue scale (VAS) on the first postoperative day, quality of life assessment using the EuroQol-5D-5L questionnaire on postoperative 10th day, deep wound dehiscence, bowel obstruction, and mortality data were recorded.
Results: In total, 112 patients were included in the study. The demographic data showed no significant difference between the groups. The median VAS score was lower in the group with open peritoneum, but this difference was not statistically significant (3 vs. 4, =0.134). The duration of surgery was significantly shorter in the peritoneal nonclosure group (31.0 ± 15.1 vs. 38.5 ± 17.5 minutes, =0.016). Overall complication rates and life quality test (EuroQol-5D-5L) results were similar between groups.
Conclusion: Nonclosure of the peritoneum seems to shorten the duration of surgery without increasing complications during open appendectomy. Postoperative pain and life quality measures were not affected by nonclosure of the peritoneum. This trial is registered with NCT02803463.

Associated Data

ClinicalTrials.gov | NCT02803463

References

  1. Radiology. 2002 Aug;224(2):325-32 [PMID: 12147823]
  2. Br J Surg. 1977 Oct;64(10):733-6 [PMID: 336132]
  3. Cochrane Database Syst Rev. 2013 Jul 04;(7):CD010424 [PMID: 23828487]
  4. Br J Surg. 1987 Feb;74(2):113-5 [PMID: 3545368]
  5. Health Policy. 1996 Jul;37(1):53-72 [PMID: 10158943]
  6. Qual Life Res. 2011 Dec;20(10):1727-36 [PMID: 21479777]
  7. J Matern Fetal Neonatal Med. 2017 Apr;30(8):922-926 [PMID: 27187047]
  8. Chirurgia (Bucur). 2014 Jul-Aug;109(4):518-22 [PMID: 25149616]
  9. Arch Trauma Res. 2013 Winter;1(4):176-9 [PMID: 24396774]
  10. J Matern Fetal Neonatal Med. 2013 Jul;26(11):1128-31 [PMID: 23350686]
  11. Ann Surg. 1939 Aug;110(2):222-30 [PMID: 17857448]
  12. Cochrane Database Syst Rev. 2014 Aug 11;(8):CD000163 [PMID: 25110856]
  13. J Surg Case Rep. 2016 Jun 23;2016(6): [PMID: 27340230]
  14. Am J Obstet Gynecol. 2012 Jan;206(1):56.e1-4 [PMID: 21924397]
  15. Saudi Med J. 2005 Jun;26(6):964-8 [PMID: 15983684]
  16. Surgery. 2010 Oct;148(4):625-35; discussion 635-7 [PMID: 20797745]
  17. World J Surg. 1990 Mar-Apr;14(2):231-3; discussion 233-4 [PMID: 2139269]
  18. J Ayub Med Coll Abbottabad. 2015 Jan-Mar;27(1):78-80 [PMID: 26182743]
  19. J Obstet Gynaecol Res. 2006 Aug;32(4):396-402 [PMID: 16882265]
  20. Qual Life Res. 2013 Sep;22(7):1717-27 [PMID: 23184421]
  21. Hernia. 2015 Jun;19(3):389-94 [PMID: 25112384]
  22. World J Surg. 1994 Mar-Apr;18(2):292 [PMID: 8042338]
  23. Health Policy. 1990 Dec;16(3):199-208 [PMID: 10109801]

MeSH Term

Adolescent
Adult
Aged
Appendectomy
Appendicitis
Double-Blind Method
Female
Humans
Laparoscopy
Male
Middle Aged
Pain, Postoperative
Peritoneum
Prospective Studies
Young Adult

Word Cloud

Created with Highcharts 10.0.0lifequalityopenpostoperativepainappendectomypatientsdataperitoneumperitonealstudyincludedusingVASdayEuroQol-5D-5Lsignificantdifferencegroupsgroupvs=0durationsurgerynonclosureNonclosurePostoperativeObjective:aimevaluateeffectclosureassociatedoperationsMethods:single-centerprospectiverandomizeddouble-blinded18-65-year-oldunderwentacuteappendicitisDemographicoperationtimelengthhospitalstayscores10cmvisualanaloguescalefirstassessmentquestionnaire10thdeepwounddehiscencebowelobstructionmortalityrecordedResults:total112demographicshowedmedianscorelowerstatistically34134significantlyshorter310 ± 151385 ± 175 minutes016OverallcomplicationratestestresultssimilarConclusion:seemsshortenwithoutincreasingcomplicationsmeasuresaffectedtrialregisteredNCT02803463PeritoneumAppendectomyMayCauseLessPain:RandomizedDouble-BlindStudy

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