Brosseuk D T, Bathe O F
Cariboo Memorial Hospital, Williams Lake, BC.
Can J Surg. 1999 Apr;42(2):138-42.
To demonstrate the safety of laparoscopic appendectomy in a day-care setting and to compare patients selected for laparoscopic versus open appendectomy.
A retrospective, nonrandomized study.
A community hospital in a small town in British Columbia.
Ninety-four consecutive patients with a clinical diagnosis of acute appendicitis.
Each patient underwent laparoscopic or open appendectomy as selected by the operating surgeon.
Duration of operation and of hospital stay, morbidity and mortality.
The average operating time was 32 minutes for open appendectomy and 36 minutes for laparoscopic appendectomy. Two (4%) of the 52 patients who had a laparoscopic appendectomy had significant complications; 1 of them required reoperation for intra-abdominal abscess. Thirty-nine (75%) of the laparoscopic appendectomies were done as day-care procedures. The average length of stay for the remaining patients was 2.1 days. The overall complication rate for patients who underwent open appendectomy was 20%. The average length of stay for these patients was 3.2 days; no patient was discharged within 24 hours.
Laparoscopic appendectomy can be safely performed as a day-care procedure, even for selected patients with gangrenous or perforated appendices. Patients typically selected for open appendectomy include children and those with more advanced infection.
证明日间手术环境下腹腔镜阑尾切除术的安全性，并比较选择腹腔镜与开腹阑尾切除术的患者情况。
一项回顾性、非随机研究。
不列颠哥伦比亚省一个小镇的社区医院。
94例连续临床诊断为急性阑尾炎的患者。
每位患者由主刀医生选择进行腹腔镜或开腹阑尾切除术。
手术时长、住院时间、发病率和死亡率。
开腹阑尾切除术的平均手术时间为32分钟，腹腔镜阑尾切除术为36分钟。52例行腹腔镜阑尾切除术的患者中有2例（4%）出现严重并发症；其中1例因腹腔脓肿需要再次手术。52例行腹腔镜阑尾切除术的患者中有39例（75%）作为日间手术进行。其余患者的平均住院时间为2.1天。接受开腹阑尾切除术患者的总体并发症发生率为20%。这些患者的平均住院时间为3.2天；无患者在24小时内出院。
即使对于某些坏疽性或穿孔性阑尾炎患者，腹腔镜阑尾切除术也可作为日间手术安全进行。通常选择开腹阑尾切除术的患者包括儿童和感染更严重的患者。
