儿童阑尾周围脓肿腹腔镜Ⅰ期手术疗效分析

目的探讨运用腹腔镜Ⅰ期阑尾切除术治疗儿童阑尾周围脓肿的临床疗效。方法收集2017年5月至2020年4月在福建医科大学附属漳州市医院接受腹腔镜Ⅰ期阑尾切除术治疗的269例儿童复杂性阑尾炎患儿的相关资料。其中, 男181例, 女88例;将45例儿童阑尾周围脓肿患儿作为A组, 224例同期收治的其他复杂阑尾炎(化脓性、坏疽性或穿孔)患儿作为B组。两组均行腹腔镜Ⅰ期阑尾切除术, 分析比较两组患儿的手术时间、住院天数、总费用、术中出血量、排气时间及并发症发生情况。结果所有患儿均行腹腔镜Ⅰ期阑尾切除术, 治疗后痊愈出院, 均无阑尾残端瘘出现。A组中位手术时间为73 min、中位住院天数为8 d、中位总费用为14 257.64元、中位术中出血量为5 ml、中位排气时间为24 h;B组中位手术时间为60 min、中位住院天数为6 d、中位总费用为11 743.84元、中位术中出血量为2 ml、中位排气时间为24 h, 两组之间的差异均具有统计学意义(P<0.05)。两组患儿在手术并发症发生率方面, A组并发症发生率分别为术后肠梗阻6.7%(3/45)、腹腔残余脓肿4.4%(2/45)、切口感染4...

Clinical analysis of laparoscopic stageⅠappendectomy for periappendiceal abscess in children

Objective To explore the clinical efficacy of laparoscopic stageⅠappendectomy in the treatment of periappendiceal abscess in children.Methods From May 2017 to April 2020,the relevant clinical data were collected from 269 children with complicated appendicitis undergoing laparoscopic stageⅠappendectomy.There were 181 boys and 88 girls.Forty-five children with periappendiceal abscess were selected as group A while another 224 hospitalized with other complex appendicitis(suppurative,gangrenous or perforated)during the same period as group B.Laparoscopic stageⅠappendectomy was performed.Operative duration,hospitalization stay,total expenditure,intraoperative volume of blood loss,exhaust time and complications were compared between two groups.Results After laparoscopic stageⅠappendectomy,all of them recovered and were discharged.No appendiceal stump fistula occurred.In group A,median operative duration was 73 min,median hospitalization stay 8 days,median total expenditure 14257.64 yuan,median volume of intraoperative blood loss 5 ml and median exhaust time 24h;in group B,median operative duration 60 min,median hospitalization stay 6 days,median total expenditure 11743.84 yuan,median volume of intraoperative blood loss 2 ml and median exhaust time 24h and the inter-group differences had statistical significance(P<0.05).The incidence rate of complications in group A was 6.7%(3/45)for postoperative intestinal ileus,4.4%(2/45)for abdominal residual abscess and 4.4%(2/45)for incision infection;the incidence rate of complications in group B was 3.1%(7/224)for postoperative intestinal obstruction,2.7%(6/224)for abdominal residual abscess and 4.5%(10/224)for incision infection and the inter-group difference had no statistical significance(P>0.05).Conclusions Laparoscopic stageⅠappendectomy for periappendiceal abscess is both safe and feasible in children.It is worthy of wider promotions and applications.