腹腔镜与开腹阑尾切除术的临床比较

目的:比较腹腔镜与开腹手术切除阑尾的优缺点。方法:回顾性分析我院2010年1月1日—2012年3月31日292例行阑尾切除术患者的临床资料,根据手术方法分为单孔法腹腔镜阑尾手术组、多孔法腹腔镜阑尾手术组和开腹阑尾手术组,比较手术时间、出血量、术后排气时间、术后住院时间切口愈合等级及感染率。结果:单孔法腹腔镜阑尾手术组中1例转为多孔法,多孔法腹腔镜阑尾手术组中1例中转开腹,其余患者均完成手术。2例多孔法腹腔镜阑尾手术患者术后并发粘连性肠梗阻,经保守治疗后好转。与传统开腹手术相比,腹腔镜阑尾切除术手术时间短、出血量少、术后排气快、术后住院时间短;对于急性单纯性阑尾炎,单孔腹腔镜手术比多孔法出血更少,瘢痕更小。结论:腹腔镜阑尾切除术对腹部干扰少,单孔法切口更为隐蔽,在熟练掌握手术技术的前提下可以广泛应用。

Comparison of laparoscopic and open approach for appendectomy

Objective： To investigate laparoscopic technique in appendectomy. Method： Retrospectively analyze 292 patients, who underwent appendectomy for appendicitis from January 2010 to March 2012, for average operation time, bleeding quantity, recovery period, hospital stay and wound complications, group by pathology and operation methods. Result： One case of single-in- cision laparoscopic appendectomy was converted to multiple-incision laparoscopic appendectomy （LA）and one case of mutiple-incision LA was coverted to open appendectomy （OA）.Two cases of multiple-incision LA complicated with intestinal obstruction and recovered after fluid treatment without surgical procedure. Co~,iusion： There were significant differences between LA and OA in operation time,hemorrhage,recovery period and hospital stay. Compared with multiple-incision LA,there was less hemorrhage in single-incision ones. Because of the umbilical cosmetic effect of sin- gle-incision technique, it is worth to exploring in clinical work.