Thorell A, Gröndal S, Schedvins K, Wallin G
Department of Surgery at Huddinge University Hospital, Karolinska Institute, Sweden.
Eur J Surg. 1999 Aug;165(8):751-4. doi: 10.1080/11024159950189528.
To assess the value of diagnostic laparoscopy in women of child-bearing age with suspected appendicitis.
Prospective, non-randomised study.
University hospital, Sweden.
94 women aged between 15 and 40 years with suspected appendicitis.
Diagnostic laparoscopy. If necessary, the appendix was removed either laparoscopically or by open operation. The outcomes were compared with those during 1994, during which all appendicectomies were done through a laparotomy.
Rates of unnecessary appendicectomy, operating time, and length of hospital stay.
77 had diagnostic laparoscopy, and 17 primary open appendicectomy. 73 appendixes were removed; 53 open and 20 laparoscopically. 12 appendicectomies (13%) were unnecessary compared with 27/80 (34%) during the year 1994. The duration of the open operation was significantly shorter (mean (SD) 35 (14) minutes) than the laparoscopic one (78 (18) minutes) (p<0.001), and there were no differences in duration of postoperative hospital stay. No patients developed complications.
Diagnostic laparoscopy is safe and helpful in suspected cases of appendicitis and could substantially reduce the rate of unnecessary appendicectomies. However, the data suggest that laparoscopic appendicectomy offers no advantages over primary open appendicectomy in terms of postoperative course.
评估诊断性腹腔镜检查在疑似阑尾炎育龄女性中的价值。
前瞻性、非随机研究。
瑞典大学医院。
94名年龄在15至40岁之间疑似阑尾炎的女性。
诊断性腹腔镜检查。必要时，通过腹腔镜或开放手术切除阑尾。将结果与1994年进行比较，1994年所有阑尾切除术均通过剖腹手术完成。
不必要阑尾切除术的发生率、手术时间和住院时间。
77例行诊断性腹腔镜检查，17例行一期开放性阑尾切除术。73例阑尾被切除；53例为开放手术，20例为腹腔镜手术。与1994年的27/80（34%）相比，12例阑尾切除术（13%）是不必要的。开放手术的持续时间明显短于腹腔镜手术（平均（标准差）35（14）分钟比78（18）分钟）（p<0.001），术后住院时间无差异。无患者发生并发症。
诊断性腹腔镜检查在疑似阑尾炎病例中安全且有帮助，可大幅降低不必要阑尾切除术的发生率。然而，数据表明腹腔镜阑尾切除术在术后病程方面并不优于一期开放性阑尾切除术。
