经脐单孔腹腔镜与开腹阑尾切除术的单中心回顾性研究  

RETROSPECTIVE COMPARISON OF SINGLE UMBILICAL-PORT LAPAROSCOPIC AND OPEN APPENDECTOMY:A SINGLE CENTER EXPERIENCE

作　　者：康春博[1] 曲军[1] 刘金洪[1] 叶博[1] 李小伟[1] 李旭斌[1] 林大鹏[1] 孟庆成[1] 王立勇[1] 

机构地区：[1]航天中心医院胃肠外科,北京市100049

出　　处：《中国煤炭工业医学杂志》2014年第11期1732-1734,共3页Chinese Journal of Coal Industry Medicine

摘　　要：目的探讨经脐单孔腹腔镜阑尾切除术的安全性及可行性。方法回顾分析该院普外科2012年1月—2013年12月,共计541例阑尾炎患者行手术治疗,其中311例行经脐单孔腹腔镜阑尾切除术,95例行传统腹腔镜下阑尾切除术,135例行开腹阑尾切除术。对比分析经脐单孔腹腔镜与开腹阑尾切除术患者的手术时间、术中出血量、术后排气时间、卧床时间、术后住院时间、术后切口感染等情况。结果单孔腹腔镜组的手术时间较开腹组明显缩短(47.5±15.1)min vs(55.3±18.2)min,P<0.05,出血量明显减少(9.8±3.5)ml vs(24.6±10.4)ml,P<0.05。在术后排气时间、术后卧床及术后住院时间方面,单孔腹腔镜组较开腹组明显缩短,分别为(18.6±5.9)h vs(30.1±10.6)h,P<0.05、(13.5±3.2)h vs(20.5±7.6)h,P<0.05及(5.2±2.1)h vs(7.6±2.8)h,P<0.05。单孔腹腔镜组的术后切口感染率、术中发现阑尾坏疽穿孔率较开腹组明显降低(1.6%vs 8.9%,P<0.05)及(9.3%vs 20%,P<0.05)。结论经脐单孔腹腔镜阑尾切除术是一安全、有效的手术方法,具有术后胃肠道功能恢复快、术后卧床及术后住院时间短及形体美观等优点,同时可以进行广泛的腹腔探查,协助急腹症的早期诊断及治疗。Objective To investigate the safety and feasibility of single umbilical-port laparoscopic appendectomy.Methods Retrospective analyzed a total of 541 patients underwent appendectomy from January2012 to December 2013,including 311 cases of single umbilical-port laparoscopic appendectomy,95 cases with conventional laparoscopic appendectomy,135 cases underwent open appendectomy.Some parameters of two groups of patients were compared such as operation room time,the amount of bleeding,postoperative evacuation time,postoperative time in bed,postoperative hospital stays,postoperative incision infection.Results Operation room time of single umbilical-port laparoscopic group was significantly shorter than the open surgery group（47.5±15.1）min vs（55.3±18.2）min,P〈0.05,the amount of bleeding was significantly reduced（9.8±3.5）ml vs（24.6±10.4）ml,P〈0.05.The postoperative evacuation time,postoperative time in bed,postoperative hospital stays and the operation room time of single umbilicalport laparoscopic group were significantly shorter than the open surgery group,it is namely（18.6±5.9）h vs（30.1±10.6）h,P〈0.05,（13.5±3.2）h vs（20.5±7.6）h,P0.05 and（5.2±2.1）h vs（7.6±2.8）h,P〈0.05 respectively.The postoperative incision infection and appendix gangrene perforation of the single umbilical-port laparoscopic group were significantly reduced than open surgery group,they were（1.6% vs 8.9%,P〈0.05）and（9.3% vs 20%,P〈0.05）respectively.Conclusions The single umbilical-port laparoscopic appendectomy is a safe,effective method of operation with the advantages of faster postoperative recovery,shorter postoperative hospitalization,postoperative bed and cosmetic results.It also can be for abdominal exploration widely,to assist the early diagnosis and treatment of acute abdomen.

关 键 词：腹腔镜 阑尾切除术 单孔 开腹手术 

分 类 号：R656.8[医药卫生—外科学]