改良三孔法腹腔镜阑尾切除术58例报告

目的：探讨改良三孔法腹腔镜阑尾切除术的临床价值。方法2011年10月～2014年2月我院行改良三孔法腹腔镜阑尾切除术58例。自耻骨联合上方约2 cm阴毛处，做2个长约5 mm横形切口，两切口相距3～5 cm，分别置入5 mm trocar，作为2个操作孔，处理阑尾及其系膜，阑尾根部用套扎线套扎，切除阑尾，阑尾标本装入异物袋取出。结果58例均顺利完成改良三孔法腹腔镜阑尾切除术，手术时间20～80 min，平均35 min；术后住院时间3～7 d，平均4 d。术后2例穿刺口感染，换药处理后切口愈合良好。58例随访3～12个月，平均8个月，无一例出现穿刺口疝和粘连性肠梗阻等并发症。结论改良三孔法腹腔镜阑尾切除术，术后瘢痕更隐蔽，美观效果更好。

Modified Three-port Laparoscopic Appendectomy in 58 Cases

Objective To explore the clinical application of modified three-port laparoscopic appendectomy. Methods A retrospective analysis was performed on clinical data of 58 patients undergoing modified three-port laparoscopic appendectomy in our hospital from October 2011 to February 2014.Two horizontal incisions 5 mm in length were made at the site about 2 cm above the pubic symphysis, with 3 -5 cm apart between each other.Two 5 mm trocars were placed into for operation.After mobilization of the appendix and its mesenteriolum, the root of the appendix was thread ligated, and the removed appendix was extracted in a bag. Results The modified three-port laparoscopic appendectomy was performed successfully in all the 58 patients.The mean operation time was 35 min （20-80 min） .The mean hospitalization time was 4 days （3-7 d） .Postoperative infection occurred in 2 patients, who were given regular dress changes until the wound healed.All the patients were followed up for 3 to 12 months, with an average of 8 months.There were no incisional hernia or adhesive intestinal obstruction or other complications. Conclusion Modified three-port laparoscopic appendectomy has advantages of better cosmetic outcomes.