腹腔镜阑尾炎阑尾切除术适应证的探讨

目的:探讨腹腔镜阑尾切除术的手术适应证及临床疗效。方法:总结2002年12月至2005年12月实施的腹腔镜阑尾切除术,分析临床适应证及手术疗效。结果:全组232例,慢性阑尾炎22例、急性单纯性阑尾炎63例、急性化脓性阑尾炎102例,坏疽性或穿孔性阑尾炎40例、阑尾周围脓肿5例,均采用腹腔镜治疗,除1例出现阑尾残端瘘外,余患者愈合良好,未出现切口感染、粘连性肠梗阻、腹腔感染等并发症。结论:随着腹腔镜技术的不断成熟、完善,对于坏疽性及穿孔性阑尾炎,阑尾周围脓肿也可在不明显增加手术并发症的情况下安全地实施,并突出腹腔镜治疗的优点。

A study on the indication of laparoscopic appendectomy

Objective To investigate the indications and therapeutic effect of laparoscopic appendectomy. Method 232 cases treated with laparoscopic appendectomy from December 2002 to December 2005 were reviewed retrospectively. Results Laparoscopic appendectomy was used in 232 cases, including 22 cases of chronic appendicitis, 63 cases of acute simple appendicitis, 102 cases of acute purulent appendicitis, 40 cases of gangrenous or perforative appendicitis and 5 cases of periappendiceal abscess. All cases had no incisional infection, adhesive ileus, abdominal cavity infection and other complications except for one case of appendix stump fistula. Conclusion With the technical improvement of laparoscopic resection, laparoscopic appendectomy can be performed safely and effectively even in the cases of gangrenous or perforative appendicitis and periappendiceal abscess, while the operation complications don't increase obviously.