悬吊式经脐两孔法腹腔镜阑尾切除术的应用研究

目的:探讨悬吊式经脐两孔法腹腔镜阑尾切除术的安全性与可行性。方法:将2014年9月至2017年3月收治的258例急性单纯性阑尾炎及慢性阑尾炎患者随机分为经脐组(n=130)与三孔组(n=128)。对比分析两组手术时间、术中出血量、术后排气时间、并发症发生率、术后腹部切口满意度、术后疼痛、住院时间。结果:两组术中出血量[(34.19±14.22)ml vs.(32.71±13.02)ml]、住院时间[(2.77±0.71)d vs.(2.83±0.76)d]、并发症发生率(0.77%vs.1.56%)差异无统计学意义;经脐组术后胃肠功能恢复较三孔组快[(12.48±5.40)h vs.(17.71±9.99)h,P<0.05],术后疼痛评分[(2.30±1.05)分vs.(3.58±1.28)分]、切口满意度评分[(4.46±0.59)分vs.(3.87±0.70)分]优于三孔组;手术时间经脐组长于三孔组[(47.67±8.04)min vs.(23.20±5.18)min,P<0.05]。术后随访1~32个月,两组均无严重并发症发生。结论:悬吊式经脐两孔法腹腔镜阑尾切除术安全、可行,术后患者胃肠功能恢复快,疼痛反应轻,腹部切口瘢痕少且隐蔽。

Application of transumbilical double-port suspended laparoscopic appendectomy

Objective:To investigate the safety and feasibility of transumbilical double-port suspended laparoscopic appendectomy.Methods:Two hundred and fifty-eight patients with acute simple or chronic appendicitis between Sep.2014 and Mar.2017 were randomly divided into two groups:transumbilical group (130 cases) and three-port group (128 cases).The operation time,intraoperative blood loss,postoperative exhaust time,complication incidence,postoperative abdominal incision satisfaction,postoperative pain and hospitalization time were compared between the two groups.Results:There was no significant difference in intraoperative blood loss [(34.19±14.22) ml vs.(32.71±13.02) ml],hospitalization time [(2.77±0.71) d vs.(2.83±0.76) d] or complication incidence (0.77％ vs.1.56％) between the two groups.The transumbilical group had better postoperative gastrointestinal function recovery [(12.48±5.40) h vs.(17.71±9.99) h,P<0.05],postoperative pain score [(2.30±1.05) vs.(3.58±1.28)] and postoperative abdominal incision satisfaction [(4.46±0.59) vs.(3.87±0.70)] compared with the three-port group.The operation time of transumbilical group was longer than that of the three-port group [(47.67±8.04) min vs.(23.20±5.18) min,P<0.05].Patients were followed up for 1-32 months,and there was no serious complication in either group.Conclusions:Transumbilical double-port suspended laparoscopic appendectomy is as safe and feasible as the traditional laparoscopic appendectomy,and is associated with quick postoperative gastrointestinal recovery,few pain,small and hidden abdominal scar.