经脐单孔腹腔镜阑尾切除术临床应用观察

目的：观察经脐单孔腹腔镜阑尾切除术（TULESSA）治疗急、慢性阑尾炎临床应用效果及安全性。方法：对2011年8月～2012年10月收治的37例阑尾炎患者行经脐单孔腹腔镜阑尾切除术（TULESSA）的临床资料进行回顾性分析。结果：本组37例患者，除1例慢性阑尾炎患者因回盲部粘连严重，阑尾游离困难，转行三孔法手术完成外，其余36例均顺利完成经脐单孔腹腔镜阑尾切除术（TULESSA），平均手术时间37．8±17．6分钟，平均排气时间26．5±11．2小时，术后平均住院时间2．7±1．5天，术后疼痛轻微，均未使用解痉镇痛药物，无腹腔及切口感染，手术切口I期愈合，术后脐部瘢痕不明显；36例患者均获得术后随访2～16个月，无脐疝、粘连性肠梗阻等并发症发生，患者调查满意度为100％。结论：经脐单孔腹腔镜阑尾切除术安全可行，具有微创、并发症少、恢复快、术后瘢痕不明显等优点，但应严格掌握握手术适应证。

Clinical application of transumbilical single - port laparoscopic appendectomy observed

Objective：To observe the transumbilical laparoendo scopic single site surgery appendectomy （TULESSA） treatment of ap- pendicitis clinical effect and security. Methods：In August 2011 to October 2012 in 37 cases of appendicitis patients Do TULESSA clinical data were retrospectively analyzed. Results： The group of 37 patients, In addition to 1 cases chronic appendicitis patients, severe adhesion of the ileocecal, Using three hole method laparoscopic appendectomy finish, The rest of the 36 cases were successfully completed TULES- SA surgery, The mean operative time （37.8 ± 17.6） min, Average exhaust time （26.5 ± 11.2）h, The mean postoperative hospital stay （2.7 ± 1.5 ） d, Postoperative pain slightly, all did not using spasmolysis analgesic drugs, No abdominal incision infection, I healing of the incision, The umbilical region scar is not obvious; 36 patients were follow - up for ：2 -16 months, There is no umbilical hernia, intestinal obstruction and other complications, satisfaction of patients was 100%. Conclusion：transumbilical laparoendo scopic single site surgery appendectomy（TULESSA） Safe and feasible, Minimally invasive, fewer complications, faster recovery, postoperative scar is not obvious merit.