经脐免气腹单孔腹腔镜辅助体外阑尾切除术治疗儿童非复杂性阑尾炎的效果观察  

作　　者：郭丽贞 洪志华 王建峰 杭天 刘俊 林厚维 

机构地区：[1]浙江中医药大学,310053 [2]嘉兴学院附属妇儿医院,314050

出　　处：《浙江临床医学》2023年第5期708-710,共3页Zhejiang Clinical Medical Journal

基　　金：嘉兴市科技计划项目(民生科技创新研究)(2021AD30113)。

摘　　要：目的探讨经脐免气腹单孔腹腔镜辅助体外阑尾切除术治疗儿童非复杂性急性阑尾炎的效果及其价值。方法收集2018年1月至2022年1月非复杂性急性阑尾炎患儿220例,分为经脐免气腹单孔腹腔镜手术(TU)组(n=122)和标准三孔腹腔镜手术(L3P)组(n=98)。比较两组患儿年龄、性别、体重指数、手术时间、术后下床活动时间、术后肠功能恢复时间、住院费用及术后并发症。结果TU组106例成功完成手术,16例术中判断不能完成改为标准三孔手术,L3P组均顺利完成,两组患儿均无中转开腹手术。TU组手术时间、住院时间比L3P组短,TU组患儿术后下床时间及术后肠功能恢复时间比L3P组早,TU组患儿总的住院费用比L3P组少,差异均有统计学意义(P>0.05)。两组患儿术后均恢复良好,随访1~3个月,TU组发生1例腹腔脓肿,1例切口积液,L3P组发生1例切口感染,均对症治疗后治愈。结论TU技术具有创伤更小、康复快、住院时间短、节约费用等优点,值得在临床推广应用。Objective To investigate the clinical effect and value of gasless transumbilical extracorporeal laparoscopic-assisted appendectomy in the treatment of uncomplicated acute appendicitis in children.Methods 220 cases of uncomplicated acute appendicitis treated in our hospital from January 2018 to January 2022 were retrospectively reviewed.Enrolled cases were divided into two groups by operative technique:the transumbilical group(TU,n=122)and the laparoscopic 3-port group(L3P,n=98).The perioperative clinical data,age,sex,body mass index(BMI),operation time,time for activity off bed,postoperative exhaustion time,hospitalization expenses and postoperative complications(incision infection,intestinal obstruction and abdominal residual abscess)were compared between the two groups.Results All the operations were successfully completed without converting to open surgery.The TU technique was successful in 106 of the 122 attempted cases(86.89%).Age,sex,and BMI of the two groups were no significant statistical difference.Compared with L3P group,the TU group had significantly shorter operative time,shorter activity off bed time,and shorter postoperative exhaust time,as well as the hospitalization time.The hospital cost of the TU group was significantly lower than that of the L3P group.All cases were followed up for 1 to 3 months and three postoperative complications were observed,two cases in TU group(one surgical wound infections,one intraabdominal abscess),one case in L3P group(one surgical wound infections).There were no significant statistical difference in the two groups.Conclusion TU technology has the advantages of less trauma,more simple,practical,safe,and cost saving,which is worthy of clinical promotion and application in primary hospitals.

关 键 词：阑尾炎 腹腔镜阑尾切除术 单孔 免气腹 儿童 

分 类 号：R726.5[医药卫生—儿科]