31例无异物残留腹腔镜阑尾切除术的疗效

目的观察无异物残留的腹腔镜阑尾切除术的疗效。方法比较无异物残留(微波刀 套扎器)腹腔镜阑尾切除术、传统(电刀 钛夹)腹腔镜阑尾切除术和开腹阑尾切除术的手术时间、手术后肠功能恢复时间、术后住院日、切口愈合情况等各项指标。结果无异物残留的腹腔镜阑尾切除术组手术时间、肛门排气时间较其它两组明显缩短(P<0.05,P<0.01);术后镇痛剂应用、住院时间、切口感染率、粘连性肠梗阻发生率及腹腔残余感染发生率等指标优于开腹阑尾切除术(P<0.01),与传统腹腔镜阑尾切除术组无明显差异(P>0.05)。结论无异物残留的腹腔镜阑尾切除术明显优于传统的腹腔镜阑尾切除术及开腹阑尾切除术。     

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目的　对比分析腹腔镜和开腹阑尾切除术在治疗穿孔性阑尾炎中的手术效果。方法　 2 0 0 0年 1月至 2 0 0 4年 1月行阑尾切除术治疗穿孔性阑尾炎 12 8例 ,其中腹腔镜阑尾切除术 5 6例 ,开腹阑尾切除术 72例。比较两种术式的手术时间、下床活动时间、术后排气时间、疼痛评分、止痛药使用率、切口感染率、置管引流率、残余脓肿发生率、住院时间和综合费用。结果　比较腹腔镜阑尾切除术组和开腹阑尾切除术组以上各指标 (除手术时间和综合费用外 )差异均有显著意义 (P <0 .0 5 )。结论　腹腔镜阑尾切除术治疗穿孔性阑尾炎和开腹阑尾切除术相比 ,具有创伤小、恢复快、并发症少和平均住院时间短等优点 ,是治疗穿孔性阑尾炎较理想的手术方式。     

穿孔性阑尾炎腹腔镜阑尾切除术疗效分析

目的观察穿孔性阑尾炎腹腔镜阑尾切除术的临床效果。方法将120例穿孔性阑尾炎患者随机分为2组,各60例。对照组采用开腹阑尾切除术,观察组实施腹腔镜阑尾切除术。结果 2组患者均顺利完成手术。2组手术时间差异无统计学意义(P 0. 05)。观察组患者术后下床活动时间、住院时间、止痛药使用率、术后并发症发生率等指标均优于对照组,差异有统计学意义(P 0. 05)。结论腹腔镜阑尾切除术治疗穿孔性阑尾炎,创伤小、并发症发生率低,术后恢复快。     

腹腔镜下阑尾切除术与传统阑尾炎手术的临床疗效观察

目的分析腹腔镜下实施阑尾切除术(LA)与传统开腹阑尾炎切除术(OA)的效果。方法将接受72例阑尾切除术的患者随机分成观察组和对照组,各36例。观察组行腹腔镜下阑尾切除术,对照组行传统开腹阑尾切除术,比较两组手术时间、术中出血量、住院时间、术后肛门恢复排气时间及术后并发症。结果观察组住院时间、术中出血量,术后肛门的恢复排气时间和并发症发生率均低于对照组,差异有统计学意义(P0.05)。2组手术时间差异无统计学意义(P0.05)。结论与开腹阑尾切除术比,腹腔镜下阑尾切除术创伤小,患者术后恢复快,但需严格掌握适应证。     

腹腔镜复杂性阑尾切除术的体会

目的:探讨腹腔镜在复杂性阑尾切除术中的应用价值。方法:回顾分析1999～2009年施行907例复杂性阑尾切除术的临床资料,其中482例行腹腔镜阑尾切除术(laparoscopic appendectomy,LA),425例行传统开腹阑尾切除术(open ap-pendectomy,OA),对比分析两组手术情况及手术效果。结果:OA组在手术时间、住院费用方面优于LA组,但差异无统计学意义(P>0.05);在肛门恢复排气时间、住院时间、术后切口感染率、术后腹腔内残余脓肿发生率及术后粘连性肠梗阻发生率方面LA组优于OA组,差异有统计学意义(P<0.05);LA组术后肠梗阻形成时间优于OA组,但差异无统计学意义(P>0.05)。结论:与传统开腹阑尾切除术相比,LA在复杂性阑尾切除术中具有明显优势,具有术后肛门排气快、住院时间短、术后感染性并发症发生率低等优点,且并不明显增加住院费用及手术时间,可作为处理复杂阑尾炎时的首选术式。     

腹腔镜阑尾切除术306例临床分析

目的探讨腹腔镜阑尾切除术的疗效,并与开腹阑尾切除术进行比较。方法选取306例腹腔镜阑尾切除术患者和302例开腹阑尾切除术患者资料,对两组患者手术时间,术中出血量,术后疼痛评分,术后肛门排气时间,平均住院天数,术后并发症发生情况进行比较。结果腹腔镜阑尾切除术组患者术后肛门排气时间、平均住院天数、切口感染发生率、粘连性肠梗阻发生率均低于开腹阑尾切除术组,差异有统计学意义(P0.05);两组手术时间、术中出血量、术后疼痛评分、腹腔脓肿发生率无明显差异(P0.05)。结论腹腔镜阑尾切除术治疗阑尾炎疗效确切,具有创伤小、恢复快、术后并发症发生率低等优点,值得推广应用。     

急性阑尾炎腹腔镜下阑尾切除术疗效观察

目的分析腹腔镜阑尾切除术治疗急性阑尾炎的临床疗效。方法将80例符合手术指征的急性阑尾炎患者随机分为对照组(行传统开腹手术)和腹腔镜组(腹腔镜阑尾切除术)两组,每组40例。比较两组平均手术时间、术后并发症、术后排气时间及住院时间。结果两组术后并发症、术后排气及住院时间差异有统计学意义(P0.05),平均手术时间差异无统计学意义(P0.05)。结论腹腔镜阑尾切除术治疗急性阑尾炎术后并发症发生率及住院时间均优于开腹手术。     

腹腔镜阑尾切除术在急性阑尾炎肥胖患者中的应用分析

目的探讨腹腔镜阑尾切除术治疗急性阑尾炎肥胖患者的临床效果。方法选取2016-01—2018-05间虞城县人民医院收治的体质量指数≥28 kg/m2的60例急性阑尾炎患者。随机分为2组,每组30例。观察组实施腹腔镜阑尾切除术,对照组行传统开腹阑尾切除术。比较2组手术时间、术中出血量、术后镇痛药物使用率、住院时间及并发症发生率等指标。结果 2组均顺利完成手术。2组手术时间差异无统计学意义(P 0. 05)。观察组术中出血量及住院时间少(短)于对照组,术后镇痛药物使用率及并发症发生率均低于对照组,差异均有统计学意义(P 0. 05)。结论对急性阑尾炎肥胖患者实施腹腔镜阑尾切除术,具有创伤小,术后并发症少,有利于术后恢复。     

急性化脓性阑尾炎腹腔镜阑尾切除术的效果

目的分析急性化脓性阑尾炎腹腔镜阑尾切除术的效果。方法将70例急性化脓性阑尾炎患者随机分为2组,每组35例。对照组实施开腹阑尾切除术,观察组实施腹腔镜阑尾切除术。比较2组手术时间、术中出血量、术后胃肠功能恢复时间、并发症发生率及住院时间等指标。结果 2组手术时间差异无统计学意义(P0.05)。观察组术中出血量、术后胃肠功能恢复时间、住院时间及并发症发生率均少于对照组,差异均有统计学意义(P0.05)。结论腹腔镜阑尾切除术治疗急性化脓性阑尾炎,创伤小、术后并发症少、恢复时间短,治疗效果好。     

腹腔镜在小儿阑尾切除术中的应用价值及对C反应蛋白的影响

目的:探讨腹腔镜小儿阑尾切除术的应用价值及对患儿血清C反应蛋白的影响。方法:2016年1~12月为100例患儿行阑尾切除术。将其分为两组,观察组行腹腔镜阑尾切除术(n=48),对照组行开腹阑尾切除术(n=52),对比两组治疗效果。结果:观察组患儿术中指标(术中出血量、手术时间、切口长度、拔管时间、镇痛药物使用率)、术后指标(遗留瘢痕率、住院费用、胃肠功能恢复时间、进食时间、抗生素使用时间)、术后并发症(腹腔残余感染、切口感染、粘连性肠梗阻)发生率明显低于对照组(P0.05);两组患儿治疗前C反应蛋白浓度差异无统计学意义(P0.05);术后第1天、第3天观察组C反应蛋白浓度更低(P0.05)。结论:腹腔镜小儿阑尾切除术创伤小,康复快,并发症少,值得推荐。     

Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis

BACKGROUND: Perforated appendicitis is associated with a significant risk of postoperative abdominal and wound infection. Only a few controversial studies evaluate the role of laparoscopy in perforated appendicitis. The significance of conversion from laparoscopy to open appendectomy for perforated appendicitis is not well defined. Statistical analysis was performed using Student's t-test. METHODS: Data on 52 patients with perforated appendicitis were prospectively collected and retrospectively reviewed. Among these patients, 18 had laparoscopic appendectomies (LA); 24 had open appendectomies (OA); and 10 had converted appendectomies (CA). The indications for either method were based on the attending surgeons's philosophy. Laparoscopic appendectomy was performed using a retrograde stapler technique. Operative time, hospital stay, ability to tolerate a liquid diet, and postoperative infectious complications were documented. RESULTS: No statistically significant difference in the operative time in minutes was found between the LA (114 +/- 29.3), CA (120.0 +/- 32.2), and OA (105.8 +/- 64.1) groups (p = NS). There was no statistically significance difference in length of stay (days) between the LA (9.2 +/- 4.1), OA (10.5 +/- 3.3), and CA (10.0 +/- 1.8) groups. The wound infection rate was less frequent in the LA group (0%) than in 0A (14%) and CA (10%) groups. The rate of intra-abdominal abscess infections (IAAs) and ileus were 22% and 28%, respectively, in LA group, 38% and 29%, respectively, in OA group, and 60% and 50%, respectively, in CA group. CONCLUSIONS: No difference in the rate of postoperative intra-abdominal abscesses exists between laparoscopic and open appendectomy for perforated appendicitis. Wound infections and ileus complicate the postoperative course of patients after laparoscopic appendectomy less frequently than after open appendectomy. The conversion of laparoscopic to open appendectomy for perforated appendicitis is associated with increased postoperative morbidity.     

腹腔镜阑尾切除术与开腹阑尾切除术治疗急性阑尾炎的临床疗效对比研究

目的 比较腹腔镜阑尾切除术(laparoscopic appendectomy,LA)与开腹阑尾切除术(open appendectomy,OA)的临床效果.方法 择取江阴市青阳医院普外科阑尾手术患者71例,根据手术方式的不同,分为LA组(37例,接受LA治疗),OA组(34例,接受OA治疗),比较两组患者手术情况、疼...     

复杂性阑尾炎术式的抉择：腹腔镜术抑或开腹手术

目的：探讨腹腔镜应用于复杂性阑尾炎的可行性。方法：回顾分析手术治疗复杂性阑尾炎213例患者的临床资料，213例分为腹腔镜阑尾切除术（laparoscopic appendectomy，LA）128例，开腹阑尾切除术（open appendectomy，OA）85例。比较两组的手术时间、术中出血量、切口长度、术中引流管留置率及术后留置时间、术后疼痛视觉模拟评分（visual analogue scale，VAS）、恢复进食时间、感染性并发症（即切口感染、腹腔内脓肿）发生率、术后住院天数、住院费用等指标。结果：LA组比OA组手术时间长，住院总费用高，差异有统计学意义；术中出血量、切口长度、术中引流管留置率及术后留置时间、术后疼痛VAS、恢复进食时间及术后住院天数等指标，IA组均优于OA组；LA组切口感染率较OA组低，腹腔内脓肿发生率两组无显著性差异。两组均无死亡病例。结论：LA具有创伤小、疼痛轻、肠道功能恢复快、切口感染率低、住院时间短等优势，用于治疗复杂性阑尾炎可行、安全、有效。     

Comparison of surgical stress between laparoscopic and open appendectomy in children

Purpose

The present study aimed to evaluate laparoscopic appendectomy (LA) in comparison with conventional open appendectomy (OA) in children, with special emphasis on the extent of surgical trauma after LA and OA, and to assess whether LA had any clear advantages compared with conventional OA.

Methods

A total of 160 patients with a median age of 7.9 years (range 3-15 years) were studied. Sixty-nine of them underwent LA, and the remaining 91 underwent OA. Serum interleukin (IL) 6 and C-reactive protein (CRP) levels which are thought to play a pivotal role in the pathogenesis of surgical trauma and can also be used to monitor the magnitude of surgical trauma were measured using an enzyme-linked immunosorbent assay before surgery and 12 hours after surgery. In addition, we compared operating time, hospital stay, incidence of wound infection, and incidence of intra-abdominal infection.

Results

The operative time of normal and suppurative appendix in the laparoscopic group was significantly shorter than that in the open group, respectively, but the operative time of gangrenous appendix was not different between the laparoscopic group and open group. The hospital stay in the laparoscopic group was also significantly shorter than that in the open group. Postoperatively, 1 patient had port-site infection in the laparoscopic group, whereas 10 had wound infection in the open group; this difference was highly significant (χ² = 4.19, P < .05). Three patients in the open group and 2 patients in the laparoscopic group had intra-abdominal infection, and the difference had no statistically significant difference (χ² = 0.10, P < .05). Preoperative IL-6 levels were not different between the 2 groups, but the rise (preoperative vs postoperative) of IL-6 in the laparoscopic group was remarkably less than that in the open group. Similar results were obtained for CRP; serum CRP levels in the basal state were not different between the 2 groups, but the rise (preoperative vs postoperative) of CRP in the laparoscopic group was also substantially less compared with that in the open group.

Conclusions

LA for children was as safe and effective as the open procedure and had significant advantages over OA because of less operating time, less postoperative complications, less surgical trauma, and more rapid postoperative recovery.     

腹腔镜阑尾切除术与传统手术疗效的比较

目的:比较腹腔镜阑尾切除术(laparoscopic appendectomy,LA)与传统开腹阑尾切除术(open appendectomy,OA)的临床疗效。方法:随机将223例阑尾炎患者分为两组,LA组115例行LA,OA组108例行OA。比较两种术式的手术时间、平均住院费用、住院时间、术后镇痛剂应用、术后24h内肛门排气例数、放置引流管率、切口感染率等。结果:LA组术后24h内肛门排气时间、放置引流管率、切口感染率、平均住院时间、粘连性肠梗阻、镇痛剂应用例数与OA组的差异有统计学意义(P<0.05);两组手术时间差异无统计学意义(P>0.05);LA组住院费用明显高于OA组(P<0.05)。结论:LA具有手术损伤小,患者疼痛轻、康复快、住院时间短、并发症少等优点,可作为多数阑尾炎患者的首选术式。     

急性阑尾炎行腹腔镜手术与开腹手术的比较

目的对比分析腹腔镜与开腹阑尾切除术在治疗急性阑尾炎中的手术效果。方法回顾性分析2009年1月至2011年10月58例行腹腔镜阑尾切除术（LA组）和同期55例行开腹阑尾切除术（OA组）的急性阑尾炎患者的临床资料,比较两种术式手术时间、下床活动时间、术后排气时间、止痛药物使用率、并发症发生率、住院时间及综合费用等指标。结果 LA组与OA组相比上述指标除手术时间外差异均有统计学意义（P〈0.05）。结论腹腔镜阑尾切除术治疗急性阑尾炎具有创伤小、恢复快、并发症少和住院时间短等优点,可作为治疗急性阑尾炎的理想选择。     

Laparoscopic appendectomy in the elderly

Background This study aimed to compare the outcomes of laparoscopic and open appendectomy among the elderly. Methods Data on 53 elderly patients with a diagnosis of suspected appendicitis were prospectively collected and retrospectively reviewed. Among these patients, 24 had undergone laparoscopic appendectomy (LA) and 29 had undergone open appendectomy (OA). The indications for either method were based on the patient’s choice. Results No statistically significant difference in operative time was found between the LA (70 ± 28 min) and OA (60 ± 22 min) groups. There was no statistically significant difference in lengths of hospital stay between the LA (4.8 ± 3.0 days) and OA (5.0 ± 3.1 days) groups, and there was a statistically significant difference in the postoperative analgesic doses between the LA (0.5 ± 0.3 doses) and OA (1.7 ± 1.5 doses) groups. No conversion of laparoscopic to open surgery was necessary, and no intraabdominal abscesses developed. Conclusion According to this study, LA is as safe and effective as OA for the elderly. Furthermore, it significantly reduces postoperative wound pain.     

遵循相同原则的腹腔镜与经腹阑尾切除术的疗效对比

目的:对比分析腹腔镜阑尾切除术(laparoscopic appendectomy,LA)与开腹阑尾切除术(open appendectomy,OA)的临床疗效。方法:回顾分析2009年1月至2011年12月为216例患者行阑尾切除术的临床资料,其中104例行LA(LA组),112例行OA(OA组)。结果:LA组出血量、疼痛程度、肠道功能恢复时间、切口感染、切口满意度、住院时间均明显优于OA组(P<0.05或<0.01),两组患者手术时间、放置引流管、治疗费用差异无统计学意义(P>0.05)。结论:遵循与OA相同的原则,LA具有出血少、术后疼痛轻、切口满意率高、住院时间短等优点,且不增加患者的手术时间与住院费用,临床优势明显。     

腹腔镜与开腹阑尾切除术治疗急性阑尾炎的疗效分析

目的 比较腹腔镜阑尾切除术(laparoscopic appendectomy,LA)和开腹阑尾切除术(open appendectomy,OA)治疗急性阑尾炎的结果.方法 将2005年5月至2010年5月收治的396例行阑尾切除术的急性阑尾炎病人按手术方法分为LA组和OA组,比较分析两组病人的临床资料.结果 LA组与...     

Adhesive small bowel obstruction after appendectomy in children: comparison between the laparoscopic and open approach

Introduction

Adhesive small bowel obstruction (SBO) is a common postoperative complication. Published data in the pediatric literature characterizing SBO are scant. Furthermore, the relationship between the risk of SBO for a given procedure is not well described. To evaluate these parameters, we reviewed the incidence of SBO after laparoscopic appendectomy (LA) and open appendectomy (OA) performed at our institution.

Methods

With institutional review board approval, all patients that developed SBO after appendectomy for appendicitis from January 1998 to June 2005 were investigated. Hospital records were reviewed to identify the details of their postappendectomy SBO. The incidences of SBO after LA and OA were compared with χ² analysis using Yates correction.

Results

During the study period, 1105 appendectomies were performed: 477 OAs (8 converted to OA during laparoscopy) and 628 LAs. After OA, 7 (6 perforated appendicitis) patients later developed SBO of which 6 required adhesiolysis. In contrast, a patient with perforated appendicitis developed SBO after LA requiring adhesiolysis (P = .01). The mean time from appendectomy to the development of intestinal obstruction for the entire group was 46 ± 32 days.

Conclusions

The overall risk of SBO after appendectomy in children is low (0.7%) and is significantly related to perforated appendicitis. Small bowel obstruction after LA appears statistically less common than OA. Laparoscopic appendectomy remains our preferred approach for both perforated and nonperforated appendectomy.