title: Comparison and efficacy of LigaSure and rubber band ligature in closing the inflamed cecal stump in a rat model of acute appendicitis.
abstract: Safety of either LigaSure or rubber band in closing inflamed appendiceal stump in acute appendicitis has been less investigated. In this study, cecal ligation followed by resecting inflamed cecum was performed to mimic appendectomy in a rat model of acute appendicitis. Rats were sacrificed immediately (Group A) and 7 days (Group B) after cecal resection, respectively. The cecal stumps were closed by silk ligature (S), 5 mm LigaSure (L), or rubber band (R). Seven days after cecal resection, the LigaSure (BL) and silk subgroups (BS) had significantly less intra-abdominal adhesion and better laparotomy wound healing than rubber band subgroup (BR). The initial bursting pressure at cecal stump was comparable among the three methods; along with tissue healing process, both BL and BS provided a higher bursting pressure than BR 7 days after appendectomy. BL subgroup had more abundant hydroxyproline deposition than BS and BR subgroup. Furthermore, serum TNF-α in BR group kept persistently increasing along with time after cecal resection. Thus, the finding that LigaSure but not rubber band is safe in sealing off the inflamed cecal stump in rat model of acute appendicitis suggests the possibility of applying LigaSure for appendectomy via single port procedure or natural orifice transluminal endoscopic surgery (NOTES).
authors.affiliation: School of Medicine, China Medical University, Taichung 40402, Taiwan ; Department of Surgery, China Medical University Hospital, Taichung 40402, Taiwan ; Division of Transplantation, University of Illinois at Chicago, Chicago, IL 60612, USA.
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Yeh
authors.affiliation: Department of Pathology, China Medical University Hospital, Taichung 40402, Taiwan ; Department of Pathology, China Medical University Beigang Hospital, Yunlin 65152, Taiwan.
authors.forename: Chia-Ing
authors.initials: CI
authors.lastname: Jan
authors.affiliation: School of Medicine, China Medical University, Taichung 40402, Taiwan ; Department of Surgery, China Medical University Hospital, Taichung 40402, Taiwan.
authors.forename: Horng-Ren
authors.initials: HR
authors.lastname: Yang
authors.affiliation: Graduate Institute of Basic Medical Science, China Medical University, 91 Hsueh-Shih Road, Taichung 40402, Taiwan.
authors.forename: Po-Han
authors.identifier: 0000-0001-7986-2911
authors.initials: PH
authors.lastname: Huang
authors.affiliation: School of Medicine, China Medical University, Taichung 40402, Taiwan ; Department of Surgery, China Medical University Hospital, Taichung 40402, Taiwan.
authors.forename: Long-Bin
authors.initials: LB
authors.lastname: Jeng
authors.affiliation: Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung 40402, Taiwan.
authors.forename: Wen-Pang
authors.initials: WP
authors.lastname: Su
authors.affiliation: Graduate Institute of Basic Medical Science, China Medical University, 91 Hsueh-Shih Road, Taichung 40402, Taiwan.
authors.forename: Hui-Chen
authors.identifier: 0000-0001-9751-5729
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000208:Acute Disease / Q000628:therapy; D000818:Animals; D001062:Appendectomy / Q000379:methods; D001064:Appendicitis / Q000378:metabolism / Q000601:surgery*; D002432:Cecum / Q000378:metabolism / Q000601:surgery*; D007249:Inflammation / Q000378:metabolism / Q000601:surgery*; D008026:Ligation / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D051381:Rats; D017207:Rats, Sprague-Dawley; D012408:Rubber; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D014409:Tumor Necrosis Factor-alpha; D012408:Rubber