单孔腹腔镜阑尾切除术的常见困难与处理  

Common difficulties and solutions in transumbilical single-port laparoscopic appendectomy

作　　者：陈生 向军[2] 谢春文 黎淑君 麦碧茹 彭俊生[2] 

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8期989-991,共3页China Journal of General Surgery

基　　金：广东省医学科研资助项目(A2011621)

摘　　要：目的:探讨经脐单孔腹腔镜行阑尾切除的手术中的常见困难与处理方法。方法:回顾性分析勒流医院2009年6月—2012年2月采取经脐单孔腹腔镜治疗的86例阑尾炎患者的临床资料。结果:处理困难包括腹腔脓液积聚15例,阑尾显露困难6例,残端处理困难5例,腹腔粘连3例;78例在单孔腹腔镜下完成手术,8例转为常规腹腔镜手术,无中转开腹者;手术时间(41.39±13.76)min,住院时间(4.82±2.16)d;全组无术后出血、切口感染等并发症。结论:单孔腹腔镜行阑尾切除手术是安全可行的;阑尾切除困难时,应视阑尾病变的情况采取相应的方法和技巧,能有效的防止并发症的发生。Objective： To investigate the common difficulties and solutions in transumbilical single-port laparoscopic appendectomy. Methods： The clinical data of 86 patients with appendicitis undergoing transumbilical single-port laparoscopic treatment in Leliu Hospital from June 2009 to February 2012 were retrospectively analyzed. Results： The difficulties encountered during operation included 15 cases of intra-abdominal abscess, 6 cases with difficulties in appendix exposure, 5 cases with difficulties in appendiceal stump treatment and 3 cases of abdominal adhesions. Single-port laparoscopic appendectomy was successfully performed in 78 cases, 8 cases were converted to conventional laparoscopic operation and there was no open conversion. The average operative time was （41.39±13.76） min and the length of postoperative hospital stay was （4.82±2.16） d. No complications such as postoperative hemorrhage and wound infection occurred in any of the patients. Conclusion： Transumbilical single-port laparoscopic appendectomy is safe and feasible. The appropriatemethods and techniques should be taken according to the appendiceal lesions when it is difficult to perform single-port laparoscopic appendectom）5 so as to effectively prevent complications.

关 键 词：阑尾炎/外科学 阑尾切除术 腹腔镜 单孔 

分 类 号：R656.8[医药卫生—外科学]