根部坏疽穿孔性阑尾炎的腹腔镜治疗

目的:探讨腹腔镜阑尾切除术(LA)治疗根部坏疽穿孔性阑尾炎的安全性和可行性。方法:总结2001年9月至2004年9月应用LA治疗45例根部坏疽穿孔性阑尾炎的临床资料,术中处理阑尾根部时,Endoloop阑尾根部直接套扎23例,间断缝合阑尾残端加医用生物蛋白胶覆盖15例,清除阑尾残余组织加医用生物蛋白胶覆盖残端放置硅胶引流管7例。结果:手术全部成功,无中转开腹,平均手术时间76.3m in,术后排气时间23.8h,11例术后使用止痛药,1例戳口感染,无肠漏及腹腔脓肿发生,平均住院时间5.5d。结论:对于根部坏疽穿孔性阑尾LA术是可行的,并具有创伤小、康复快、并发症少等优点。

Laparoscopic appendectomy for root gangrenous perforative appendicitis

Objective:To explore the feasibility and safety of laparoscopic appendectomy(LA) for root gangrenous perforative appendicitis.Methods:Forty-five patients with root gangrenous perforative appendicitis were treated with laparoscopic appendectomy from September 2001 to September 2004,and the clinic data were analyzed.Results:All operations were successful and no one was converted to open surgery.The mean length of operation time was 76.3 minutes.The exhaust time was 23.8 hours after operation.11 cases were treated with antalgica after operation.l case had pore infection.No case appears residual abscess and colic fistula.The mean time for hospitalization was 5.5 days.Conclusions:Laparoscopic appendectomy for root gangrenous perforative appendicitis is safe and feasible,with advantages of minimal invasion,early recovery,few complications.