腹腔镜与开腹阑尾切除术的前瞻性随机多中心研究

Prospective randomized multicentre study of laparoscopic versus open appendicectomy.

作者信息

Hellberg A, Rudberg C, Kullman E, Enochsson L, Fenyö G, Graffner H, Hallerbäck B, Johansson B, Anderberg B, Wenner J, Ringqvist I, Sörensen S

机构信息

Department of Surgery, Central Hospital, Västerås, Sweden.

出版信息

Br J Surg. 1999 Jan;86(1):48-53. doi: 10.1046/j.1365-2168.1999.00971.x.

DOI:10.1046/j.1365-2168.1999.00971.x

PMID:10027359

Abstract

BACKGROUND

A prospective randomized multicentre study was performed to compare the outcome of laparoscopic and open appendicectomy in patients with suspected acute appendicitis.

METHODS

A total of 523 patients was randomized, but because of 23 withdrawals the outcome in 500 patients is reported, 244 in the laparoscopic group and 256 in the open group.

RESULTS

Patients having laparoscopic appendicectomy recovered more quickly than those having open surgery (13 versus 21 days, P < 0.001). There was no significant difference in duration of sick leave after operation (laparoscopic group 11 days versus open group 14 days). Postoperative pain (at 24 h, 7 days and 14 days) was less after laparoscopic operations and a functional index 1 week after operation was more favourable in these patients (P < 0.001). Operating time was significantly longer in the laparoscopic group (60 versus 35 min, P < 0.01). Hospital stay and complications did not differ between the groups. Thirty laparoscopic procedures (12 per cent) were converted to open appendicectomy.

CONCLUSION

Laparoscopic appendicectomy is as safe as open appendicectomy and has the advantage of allowing a quicker recovery.

摘要

背景

开展了一项前瞻性随机多中心研究，以比较疑似急性阑尾炎患者行腹腔镜阑尾切除术和开腹阑尾切除术的结果。

方法

共有523例患者被随机分组，但因23例退出研究，故报告了500例患者的结果，其中腹腔镜组244例，开腹组256例。

结果

行腹腔镜阑尾切除术的患者比行开腹手术的患者恢复得更快（分别为13天和21天，P<0.001）。术后病假时长无显著差异（腹腔镜组11天，开腹组14天）。腹腔镜手术后的术后疼痛（术后24小时、7天和14天）较轻，且这些患者术后1周的功能指标更优（P<0.001）。腹腔镜组的手术时间明显更长（分别为60分钟和35分钟，P<0.01）。两组的住院时间和并发症无差异。30例腹腔镜手术（12%）中转开腹阑尾切除术。