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机构地区:[1]广东省佛山市顺德区勒流医院普通外科,广东佛山528322 [2]中山大学附属第六医院胃肠外科,广东广州510665
出 处:《中国普通外科杂志》2012年第4期447-450,共4页China Journal of General Surgery
基 金:广东省医学科研资助项目(A2011621)
摘 要:目的:探讨单孔腹腔镜阑尾切除手术的可行性。方法:对2011年1月—2011年12月收治的122例急性阑尾炎病例,按照随机原则分单孔腹腔镜组(61例)和常规腹腔镜组(61例),对两组的手术时间、术中出血量、肠道功能恢复时间、住院时间、并发症、中转率进行比较。结果:两组在术中出血量、术后肠道功能恢复时间、住院时间及术后并发症的比较,差异均无统计学意义(P>0.05),单孔腹腔镜组因粘连(2例)和腹膜后阑尾(1例)中转常规腹腔镜手术;坏疽性(穿孔性)阑尾炎的手术时间,单孔腹腔镜组明显长于常规腹腔镜组(P=0.004);单纯性阑尾炎和化脓性阑尾炎两组的手术时间无统计学差异(P>0.05)。结论:选择性对急性阑尾炎行单孔腹腔镜手术治疗是安全可行的;与常规腹腔镜比较,单孔腹腔镜治疗单纯性阑尾炎和化脓性阑尾炎同样具有恢复快、创伤小的优点,且比常规腹腔镜有更好的维护形体的效果。Objective: To study the feasibility of transumbilical single-port laparoscopic appendectomy. Methods: One hundred and twenty-two patients with acute appendicitis from January 2011 to December 2011 were randomly assigned to undergo transumbilical single-port laparoscopic appendectomy or conventional laparoscopic appendectomy, with 61 cases in each group. The operative time, intraoperative blood loss, time to intestinal function recovery, length of hospital stay, complications and the conversion rate between the two groups were compared. Results: There were no statistical differences in intraoperative blood loss, time to bowel function recovery length of hospital stay and complications between the two groups. Of the patients undergoing transumbilical single-port laparoscopic procedure, 2 cases with severe adhesions and 1 case of retroperitoneal appendix were converted to conventional laparoscopic appendectomy. For patients with gangrenous or perforated appendicitis, the operative time of the transumbilical single-port laparoscopic procedure was significantly longer than that of the conventional laparoscopic procedure (P=0.004). The operative times had no significant difference between the two procedures for patients with simple or suppurative appendicitis. Conclusion: Selective use of transumbilical single-port laparoscopic procedure for appendectomy is feasible and safe. For patients with simple or suppurative appendicitis, it has the advantages of quick recovery, little invasiveness and better cosmetic results compared with the conventional procedure.
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