值班外科医生是决定是否采用腹腔镜阑尾切除术的一个重要因素。

The surgeon on call is a strong factor determining the use of a laparoscopic approach for appendectomy.

作者信息

Cervini P, Smith L C, Urbach D R

机构信息

Minimally Invasive Surgery Program, Division of General Surgery, Toronto Western Hospital, 399 Bathurst Street, Room MP 8-332, Toronto, Ontario M5T 2S8.

出版信息

Surg Endosc. 2002 Dec;16(12):1774-7. doi: 10.1007/s00464-002-8521-7. Epub 2002 Jul 29.

DOI:10.1007/s00464-002-8521-7

PMID:12140626

Abstract

BACKGROUND

Laparoscopic and open approaches are commonly used for appendectomy. No previous studies have specifically examined which factors determine whether a laparoscopic or open approach is used for appendectomy.

METHODS

We conducted a retrospective chart review of 140 patients who underwent a laparoscopic (n = 60) or open (n = 80) appendectomy between January 2000 and April 2001 at our hospital. Medical records were reviewed, and the data were analyzed using chi-square analysis, the Wilcoxon rank-sum test, and multivariate logistic regression. We studied patient age, gender, type of surgeon on call, leukocyte count, pathology, and the use of diagnostic imaging to determine whether there was any association with the use of a laparoscopic approach.

RESULTS

The type of surgeon on call was strongly correlated with a laparoscopic approach. Of the 61 appendectomies performed by laparoscopic surgeons (those who use laparoscopy for operations other than appendectomies and cholecystectomies), 55 (90%) were laparoscopic and 6 (10%) were open. Of the 79 appendectomies performed by nonlaparoscopic surgeons, 5 (6%) were laparoscopic and 74 (94%) were open (multivariate odds ratio, 136; 95% confidence interval, 39-475; p < 0.001).

CONCLUSIONS

The surgeon on call when a patient is admitted is an important factor determining whether a patient will receive a laparoscopic or open appendectomy.

摘要

背景

腹腔镜和开放手术方法常用于阑尾切除术。以前没有研究专门探讨哪些因素决定了阑尾切除术采用腹腔镜还是开放手术方法。

方法

我们对2000年1月至2001年4月在我院接受腹腔镜（n = 60）或开放（n = 80）阑尾切除术的140例患者进行了回顾性病历审查。审查了病历，并使用卡方分析、威尔科克森秩和检验和多变量逻辑回归对数据进行了分析。我们研究了患者年龄、性别、值班外科医生类型、白细胞计数、病理以及诊断性影像学检查的使用情况，以确定是否与腹腔镜手术方法的使用存在任何关联。

结果

值班外科医生类型与腹腔镜手术方法密切相关。在由腹腔镜外科医生（那些在阑尾切除术和胆囊切除术以外的手术中使用腹腔镜的医生）进行的61例阑尾切除术中，55例（90%）为腹腔镜手术，6例（10%）为开放手术。在由非腹腔镜外科医生进行的79例阑尾切除术中，5例（6%）为腹腔镜手术，74例（94%）为开放手术（多变量比值比，136；95%置信区间，39 - 475；p < 0.001）。