Laparoscopic appendectomy in complicated appendicitis with compromised appendix base: a retrospective cohort study.

Background: Patients with compromised appendix base constitute a subgroup of patients with complicated appendicitis, and there is few available information.
Objective: To study the frequency of stump leaks and fistulae in patients with complicated appendicitis with compromised stump.
Method: This is an observational, retrospective study of patients that underwent laparoscopic appendectomy with compromised appendix stump.
Results: From 2015 to 2019, 158 patients with complicated appendicitis were operated, of them 54 had compromised base or stump. There were 66.7% men, with a mean age of 38.7 years. For stump closure, a simple knot was employed in 57.4%, and in 42.6% an invaginated suture was employed. Regarding complications, 16.7% developed intraabdominal abscess, 7.4% ileus and 7.4% had wound infection. We found one stump leak and one stump fistula. The mean length of stay was 5.4 days (range: 1-20). There were 5 reoperations, 4 for abscess drainage and 1 for stump leak.
Conclusions: Patients with acute complicated appendicitis with compromised appendicular base, laparoscopic surgery either with simple knot or with invaginated suture resulted in low frequency of stump leaks and fistula.
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