单切口腹腔镜与传统腹腔镜阑尾切除术比较  

Single-incision laparoscopic appendectomy and traditional triple-hole laparoscopic appendectomy:A comparative study

作　　者：沈笛[1] 杜晓辉[1] 邱朔 李松岩[1] 刘利利[1] 王淼[2] 

机构地区：[1]解放军总医院普通外科,北京100853 [2]铁岭市公安局清河刑警技术中队法医室,辽宁铁岭112000

出　　处：《军医进修学院学报》2012年第8期825-827,共3页Academic Journal of Pla Postgraduate Medical School

基　　金："十一五"军队医药卫生科研基金(06G107);北京市科技新星计划资助项目(2006A51)~~

摘　　要：目的介绍单切口腹腔镜下阑尾切除术的方法和体会。方法选取我院2009年10月-2010年3月50例阑尾炎患者,在脐周建立三戳孔,对称安置3个Trocar(1个12mm Trocar,2个5mm Trocar),腹腔镜下切除阑尾并以12mm Trocar或扩切至20mm(国际惯例认定:切口长度>20mm的切口称之为单切口)将标本取出。若阑尾标本较粗大,可将其中2个5mmTrocar孔或1个5mm Trocar和12mm Trocar融合成新的单切口,然后将标本取出。传统的三孔法腹腔镜下阑尾切除术(50例),即在腹部正中线脐旁5mm处置入5mmTrocar,脐下6-7mm处置入12mm Trocar,反麦氏点置入5mm Trocar进行手术。结果平均手术时间15min(10-20min),住院时间2-3d,腹部未见明显瘢痕,均无切口感染,50例患者均未见阑尾残株炎、肠粘连等并发症。结论单切口腹腔镜下阑尾切除术操作简单,创伤极小,手术安全。Objective To describe the methods of single-incision laparoscopic appendectomy and our experience with it.Methods Fifty patients with appendicitis admitted to our hospital from October 2009 to March 2010 were enrolled in this study.The patients underwent single-incision laparoscopic appendectomy with 3 trocars inserted around the umbilicus（one was 12mm long and two were 5mm long）.The incision was called a single incision when its length was 〉20mm.The appendix was pulled out from the 12mm-long trocar.If the appendix was large,two 5mm-long trocars or one 5mm-long trocar was fused into a single incision to form a new single incision to remove the appendix.Then,the outcomes of single-incision laparoscopic appendectomy and traditional triple-hole laparoscopic appendectomy were compared.Results The average operation time of single-incision laparoscopic appendectomy was 15min（range 10-20min）.The hospital stay time of the patients was 2-3days after operation.No obvious abdominal scar formation,incision infection,appendix stump inflammation and adhesion occurred after operation.Conclusion Single-incision laparoscopic appendectomy is a simple and safe procedure for appendicitis with extremely small trauma.

关 键 词：单切口 腹腔镜 阑尾切除术 

分 类 号：R651[医药卫生—外科学]