Assessment of the haematological profile after appendectomy using linear titanium stapler clips: an experimental study in rats
Abstract
Introduction: The technique of closing the appendiceal stump using linear titanium stapler clips is being used more and more frequently in laparoscopic surgery, despite the good practice in the use of resorbable single endoloop vicryl ligatures and/or the non-resorbable plastic hem-o-lok clips. No light has been shed on potential undesirable effects on the haemathological profile of the use of titanium stapler clips. This experimental study aimed at establishing any possible undesirable effect of linear titanium stapler clips and single resorbable vicryl endoloop ligatures on the blood cells in rats following appendectomy.
Methods: A total of 70 adult rats were used, divided into a control group (n = 10), and two experimental groups (n = 30 + 30). The appendices were removed from the rats in the first experimental group using titanium stapler clips and in the second experimental group the appendiceal stump using resorbable endoloop vicryl ligatures was closed. In both experimental groups three sub-groups with ten animals each were formed, from which peripheral blood from a tail vein on days 7, 28 and 60 was removed postoperatively, in order to assess the usual haematological parameters. Stained blood smears were also analysed in order to establish any poikilocytotic erythrocytes present.
Results: In the first experimental group, with the titanium stapler clips, more than 25 % neutrophils were found on day 7, which is a significantly different result (p < 0.05) to the control group. In the second experimental group, there were more neutrophils than in the titanium stapler clips group, especially on days 7 and 60 and the results of these two sub-groups differ statistically significantly, p < 0.05. Hypochromia was found in the endoloop vicryl ligatures group, as well as in the titanium stapler clips sub-group on day 28, due to lower haemoglobin values which were significantly different to the control group, p < 0.05. Moderate levels of annulocytes, spherocytes and stomatocytes were found in most experimental groups.
Conclusion: The results of this study favour the use of linear titanium stapler clips over resorbable single endoloop vicryl ligatures, because a less unfavourable effect was established on the blood cells of the experimental rats with their use.
References
Delibegović S, Simatović M. Hirugija tankog crijeva i crvuljka. In: Delibegović S, Krdžalić G, Pašić F, eds. Hirurgija/Kirurgija. Sarajevo: Dobra knjiga-UEHBH; 2020: 499-513.
Delibegovic S, Katica, M, Latic F, Jakic-Razumovic J, Koluh A, Njoum MTM. Biocompatibility and adhesion formation of different endoloop ligatures in securing the base of the appendix. JSLS 2013;17: 543-8. DOI: 10.4293/108680813X13654754534116
Bajrić A, Katica M, Katica A, Smajović A, Sivić M, Rukavina R,et al. Assessment of Hematological Parameters After Laparoscopic AppendectomyUsing Conventional Procedures on Rats. Veterinaria 2020;69(3):165-73.
Delibegovic S, Iljazovic E, Katica M, Koluh A. Tissue Reaction to Absorbable Endoloop, Nonabsorbable Titanium Staples, and Poly-mer Hem-o-lok Clip After Laparoscopic Appendectomy. JSLS 2011;15:70-6. DOI: 10.4293/108680811X13022985131336
Kavic MS, Kavic SM, Kavic SM. 2012. Laparoscopic Appendectomy. In: Kavic MS, Nezhat C, Winfield H. eds. Prevention and Management of Laparoendoscopic Surgical Complications. 3rd ed. Miami: FL: SLS; 2012.
Soper NJ, Scott-Conner Carol EH, eds.The SAGES Manual. Vol. 1. Basic Laparoscopy and Endoscopy. New York: Springer-Verlag; 2012.
Delibegović S, Katica M, Koluh A. Formation of Adhesions after Laparoscopic Apedenctomy. In: Marmo AS, ed. Appendicitis. New York: Nova Science Publisher; 2014:207-17.
Horzić M, Salamon A, Kopljar M, Skupnjak M, Cupurdija K, Vanjak D. Analysis of scores in diagnosis of acute appendicitis in women. Coll Antropol 2005;29(1):133–8.
Khan MN, Davie E, Irshad K. The role of white cell count and c-reactive protein in the diagnosis of acute appendicitis. J Ayub Med Coll Abbottabad 2004;16(3):17–9.
Gulzar S, Umar S, Dar GM, Rasheed R. Acute appendicitisrole of clinical examination in making a confident diagnosis. Pak J Med Sci 2005;21(2):125–32.
Shoshatari MHS, Askarpour S, Alamshah M, Elahi A. diagnostic value of quantitative CRP measurement in patients with acute appendicitis. Pak J Med Sci 2006;22(3):300–3.
Kamran H, Naveed D, Nazir A, Hameed M, Ahmed M, Khan U. Role of total leukocyte count indiagnosis of acute appendicitis. J Ayub Med Coll Abbottabad 2008;20:70-1.
Baptista ML, Bonsack ME, Felemovicius I, Delaney JP. Abdominal adhaesions to prosthetic mesh evaluated by laparoscopy and electronic microscopy. J Am Coll Sur 2000;19: 271-80.
Kosan M, Gonulalan U, Ozturk B, Kulacoglu S, Erguder I, Akdemir O, et al. Tissue reactions of suture materials(polyglactine 910, chromed catgut and polydioxa-none) on rat bladder wall and their role in bladder stone formation. Urol Res 2008;36:43– 9.
Spahić E, Katica M, Jogunčić A, Katica A, Hasić S. Impact of temperature and the length of exposure on morphological characteristics of erythrocytes in antemortem and postmortem analysis: Experimental study on Wistar rats. Kafkas Univ Vet Fak Derg 2020; 26 (6):771-6. DOI: 10.9775/kvfd.2020.24352
Katica M, Janković O, Tandir F, Gradaščević N, Dekić R, Manojlović M, et al. The effects of calcium aluminate and calcium silicate cements implantation on haematological profile in rats. Kafkas Univ Vet Fak Derg 2020;26(3):427-34. DOI: 10.9775/kvfd.2019.23476.
Katica M, Šeho-Alić A, Čelebičić M, Prašović S, Hadžimusić N, Alić A. Histopathological and hematological changes by head abscess in rat. Veterinaria, 2019; 68 (3):151-156.
IBM Corp. Released, 2016. IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.
Hanke PR, Timm P, Falk G, Kramer W. Behavior of different suture materials in the urinary bladder of the rabbit with special reference to wound healing, epithelization and crystallization. Urol Int1994;52:26 –33.
Katica M, Delibegović S. 2019. Laboratorijske životinje- Osnovne tehnike eksperimentalnog rada. Sarajevo: Dobra Knjiga; 2019:41-62.
Kampfmann I, Bauer N, Johannes S, Moritz A. Differences in hematologic variables in rats of the same strain but different origin. Vet Clin Pathol 2012;41(2):228-34. DOI: 10.1111/j.1939-165X.2012.00427.x
Lelovas P, Stasinopoulou M, Balafas E, Nikita M, Siskos N, Kostomitsopoulos N. Valuation of three different anesthetic protocols on complete blood count and biochemical parameters on Wistar rats. J Hell Vet Med Soc2017; 68(4): 587-98.
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