腹腔镜与传统开放阑尾切除术的比较研究

目的对比分析隐蔽三孔法腹腔镜阑尾切除术(LA)与传统开放阑尾切除术(OA)在治疗阑尾炎中的手术效果。方法将137例阑尾炎病例随机分为两组,一组65例行隐蔽三孔法LA,另一组72例行OA。比较两种术式的手术时间、术后肛门排气时间、住院时间、住院费用、止痛剂使用率、放引流管率、切口感染发生率、粘连性肠梗阻发生率等。结果LA组术后肛门排气时间、住院时间、止痛剂使用率、放引流管率、切口感染发生率、粘连性肠梗阻发生率均较OA组明显降低(P<0.05),两组手术时间的差异无统计学意义(P>0.05),LA组住院费用较OA组明显增加(P<0.05)。结论隐蔽三孔法LA具有切口小、隐蔽,双极电凝阶梯凝闭法简单有效,阑尾根部以可吸收线Roeder结套扎安全简便,无异物残留等优点,与OA相比,行LA者创伤小、恢复快、并发症少和住院时间短,可作为绝大多数阑尾炎的首选术式。

Comparison study on laparoscopic appendectomy and conventional appendectomy

Objective To make a comparison study on the therapeutic effects of three-trocar technique in LA(laparoscopic appendectomy) and conventional open appendectomy in treating appendicitis.Methods Patients with appendicitis were divided into two group randomly,in one group(n=65) ,patients were treated with three trocar technique in LA and in the other group(n=72) ,patients were treated with open appendectomy(OP) .The operation duration?average time of postoperative gas-passing?hospitalization ?hospital cost?usage of pain killer?drainage placement ?incision infection rate and incidence rate of adhesive intestinal obstruction were compared.Results The index above showed significant difference between the two groups(P<0.05) ,there was no significant difference in operation duration between the two groups(P>0.05) ,the hospital cost of LA group was significantly higher that of OA group(P<0.05) .Conclusion Three trocar techniques in LA has its advantages of small incision ?a safe and simple step-electrocoagulation with bipolar coagulator?safely closure of stump by Roeder loops and no remnant foreign bodies.Compared with OA,three trocar techniques in LA is minimal invasive with quicker recovery ?less complications and shorter hospitalization.Though higher in expense,the cost effectiveness overall makes it the first choice operation to treat appendicitis.