经脐单孔腹腔镜阑尾切除术92例临床分析

目的:探讨经脐单孔腹腔镜阑尾切除术(laparoscopic appendectomy,LA)治疗阑尾炎的疗效及手术价值。方法:回顾分析2013年5月至2015年4月92例经脐单孔LA患者的临床资料。术中使用常规腹腔镜器械完成手术,无特殊器械。结果:92例患者中83例成功施行单孔LA,成功率90.2%。术中出血量10～34 ml,平均(15.26±5.36)ml;术后排气时间8～28 h,平均(14.12±2.46)h;住院2～7 d,平均(3.0±1.81)d,92例均治愈出院。术后病理证实急性单纯性阑尾炎47例、慢性阑尾炎16例、化脓性阑尾炎20例、坏疽性阑尾炎9例。83例随访3～12个月,均无严重并发症发生。结论:经脐单孔LA对器械要求不高,可在基层医院开展,并以腹部切口少、美观、术后康复快等特点逐渐被患者尤其年轻女性患者所接受,能较好地避免开腹手术切口感染、不愈合等并发症。

Clinical analysis of 92 cases of transumbilical single port laparoscopic appendectomy

Objective:To investigate the effect and value of the transumbilical single port laparoscopic appendectomy in treat-ment of appendicitis. Methods:Clinical data of 92 cases of transumbilical single port laparoscopic appendectomy from May 2013 to Apr. 2015 were retrospectively analyzed. Conventional laparoscopic instruments were used in the operation. Results:Single port transum-bilical laparoscopic appendectomy was successfully performed in 83 of 92 patients with a success rate of 90. 2%. The amount of intraop-erative bleeding was 10-34 ml,with an average of (15. 26±5. 36) ml. The postoperative exhaust time was 8 to 28 h,with an average of (14. 12±2. 46) h. The hospitalization time was 2 to 7 d,with an average of (3. 0±1. 81) d. All of the 92 patients made full recovery. The postoperative pathology indicated 47 cases of acute appendicitis,16 cases of chronic appendicitis,20 cases of suppurative appendi-citis and 9 cases of gangrenous appendicitis. 83 patients did not suffer from serious complications during the follow-up of 3 to 12 months. Conclusions:Transumbilical single port laparoscopic appendectomy has no high requirement for instruments and it can be car-ried out in primary hospitals. This procedure is gradually accepted by patients especially young women because of some advantages such as few abdominal incisions,aesthetic value and fast recovery. Compared with laparotomy,postoperative complications such as incision in-fection and non-healing are fewer in transumbilical single port laparoscopic appendectomy.