急性阑尾炎腹腔镜手术与开腹手术的临床比较

目的比较腹腔镜手术与开腹手术在急性阑尾炎中手术时间、住院时间、并发症、术后镇痛与医疗费用。方法 206例急性阑尾炎患者随机分入腹腔镜手术(LA)组和开腹手术(OA)组,比较两组间手术时间、住院时间、感染并发症和医疗费用。结果 88%的患者经病理诊断为阑尾炎,两组间性别、年龄比较无统计学差异。感染并发症、住院时间组间比较无统计学差异(p>0.05)。LA组手术时间比OA组长(p>0.05);医疗费用LA组较高(p<0.05)。结论与传统开腹手术比较,腹腔镜手术治疗急性阑尾炎无明显临床优势。

LAPAROSCOPIC VERSUS OPEN APPENDECTOMY IN ACUTE APPENDICITIS

Objectives To compare laparoscopic appendectomy with open appendectomy for length of operation, complications, postoperative pain control, length of hospitalization, and hospital costs. Methods A sample of 206 patients who underwent OA and LA during 2008 - 2010 was randomly selected for the study. Patients＇ demographic data, preoperative laboratory and physical values, histopathological diagnosis of removed appendix, mean operating time, length of hospitalization, and complications were reviewed. Results Acute appendicitis was confirmed in 88% of patients. The groups were similar demographically （gender and mean age）. We could not find any statistical differences in intraoperative and postoperative complications. The operative time was longer in the LA group （p 〈 0. 05 ）. The hospital stay was 4. 6 days in the LA group and 5.2 days in the OA group. Higher operative costs were observed in the LA group. Conclusion Laparoscopic appendectomy is more costly and does not offer any significant benefit over the open approach.