A Totally Laparoscopic Colectomy is Feasible for Acute Complicated Appendicitis with Necrotic Appendiceal Base in the Emergency Setting

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 Ã+- 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.