腹腔镜下阑尾切除术中残端沿阑尾基底沟荷包缝合与Endoloop套扎的临床疗效比较  

Comparison of clinical efficacy between purse-string suture and Endoloop ligation of appendix stump in laparoscopic appendectomy

作　　者：陈绪涛 CHEN Xu-tao(Gastrointestinal Surgery Department,Xintai People's Hospital,Xintai 271200,China)

机构地区：[1]山东省新泰市人民医院胃肠外科,271200

出　　处：《中国实用医药》2023年第21期36-40,共5页China Practical Medicine

摘　　要：目的探讨腹腔镜下阑尾切除术中残端沿阑尾基底沟荷包缝合与圈套器(商品名:Endoloop)套扎的临床疗效。方法132例急性阑尾炎患者作为研究对象,根据阑尾残端处理方式的不同分为荷包缝合组(57例)和套扎组(75例)。两组患者均行腹腔镜下阑尾切除术治疗,荷包缝合组残端采用阑尾基底沟荷包缝合,套扎组残端采用Endoloop套扎。比较两组手术时间、术后肛门恢复排气时间、术后住院时间、术后并发症发生情况。结果两组均顺利完成腹腔镜下阑尾切除术,无中转开腹手术患者。两组术后肛门恢复排气时间比较差异无统计学意义(P>0.05)。荷包缝合组手术时间(78±28)min稍长于套扎组的(72±21)min,但差异无统计学意义(P>0.05)。荷包缝合组术后住院时间(5.2±1.4)d短于套扎组的(6.3±1.7)d,差异有统计学意义(P<0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05);套扎组有2例体质量指数(BMI)分别为16.3 kg/m^(2)和19.2 kg/m^(2)的患者均术后右下腹隐痛持续1~2个月,B超检查均未见阑尾区积液。所有患者出院后1周、1个月、6个月随访3次,截止2023年5月无失访病例,随访率100%。结论腹腔镜下阑尾切除术中残端沿阑尾基底沟荷包缝合与Endoloop套扎均可对阑尾残端进行安全处理,沿阑尾基底沟行荷包缝合易于包埋残端,可缩短手术时间,患者术后恢复较快,住院时间较短。Objective To discuss the clinical efficacy between purse-string suture and Endoloop ligation of appendix stump in laparoscopic appendectomy.Methods A total of 132 patients with acute appendicitis were selected as the study subjects and divided into the purse-string suture group(57 cases)and the ligation group(75 cases)according to the different treatment methods of appendix stump.Laparoscopic appendectomy was performed in both groups.The purse-string suture group received purse-string suture of appendix stump,and the ligation group received Endoloop ligation of appendix stump.The operative time,postoperative bowel function recovery time,postoperative hospital stay,and postoperative complications were compared between the two groups.Results Both groups successfully completed laparoscopic appendectomy,and no conversion to open surgery.There was no statistically significant difference in postoperative bowel function recovery time between the two groups(P>0.05).The operative time of(78±28)min in the purse-string suture group was slightly longer than that of(72±21)min in the ligation group,but the difference was not statistically significant(P>0.05).The postoperative hospital stay of(5.2±1.4)d in the purse-string suture group was shorter than that of(6.3±1.7)d in the ligation group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05),there were 2 patients in the ligation group with body mass index(BMI)of 16.3 kg/m2 and 19.2 kg/m2,respectively.The right lower abdominal pain persisted for 1-2 months after surgery,and no fluid accumulation was found in the appendix area on ultrasound examination.All patients were followed up 3 times after discharge at 1 week,1 month and 6 months.By May 2023,there were no lost to follow up cases,and the follow-up rate was 100%.Conclusion In laparoscopic appendectomy,both purse-string suture and Endoloop ligation can safely dispose of the appendiceal stum

关 键 词：急性阑尾炎 腹腔镜下阑尾切除术 阑尾残端 荷包缝合 圈套器套扎 

分 类 号：R656.8[医药卫生—外科学]