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腹腔镜阑尾切除术:沙特一家医院7年331例病例回顾

Laparoscopic appendicectomy: review of 331 cases over 7 years, in a Saudi Arabian hospital.

作者信息

Tucker O, Rashid Al-Faqih S, El-Amin O, Zaki A

机构信息

St. James's Hospital, Dublin, Ireland.

出版信息

Endoscopy. 2002 Aug;34(8):639-42. doi: 10.1055/s-2002-33241.

Abstract

BACKGROUND AND STUDY AIMS

Laparoscopic appendicectomy had been well established by Semm before the popular breakthrough of laparoscopic cholecystectomy. The aim of this study was to evaluate the role of laparoscopy in the diagnosis and treatment of acute appendicitis.

PATIENTS AND METHODS

This is a retrospective study. Patients with signs and symptoms of suspected appendicitis necessitating surgery were selected for laparoscopic management between 1992 and 1999.

RESULTS

A total of 331 patients were recruited into the study, 184 (56 %) male and 147 (44 %) female. The appendix was successfully removed laparoscopically in 98 % of the patients. The median operating time was 63.3 minutes, and 93 % of the appendices removed were histologically abnormal. Postoperative complications occurred in 19 patients (6 %), and included wound infection (1 %), enterocutaneous fistula, pelvic abscess, hemorrhage, urinary tract infection, respiratory tract infection, incisional herniae and pain at trocar sites. The mean hospital stay was 2.31 days (range 1 - 10 days).

CONCLUSION

Laparoscopic appendicectomy is a safe procedure with low morbidity. It is advantageous in obese patients, patients with other pathology, and patients with an unusual position of the appendix, and it has a low infection rate.

摘要

背景与研究目的

在腹腔镜胆囊切除术取得广泛突破之前,Semm就已成功开展了腹腔镜阑尾切除术。本研究旨在评估腹腔镜检查在急性阑尾炎诊断和治疗中的作用。

患者与方法

这是一项回顾性研究。选取1992年至1999年间因疑似阑尾炎症状体征而需手术治疗的患者进行腹腔镜手术治疗。

结果

本研究共纳入331例患者,其中男性184例(56%),女性147例(44%)。98%的患者通过腹腔镜成功切除阑尾。中位手术时间为63.3分钟,93%切除的阑尾组织学检查异常。19例患者(6%)出现术后并发症,包括伤口感染(1%)、肠皮肤瘘、盆腔脓肿、出血、尿路感染、呼吸道感染、切口疝和套管针部位疼痛。平均住院时间为2.31天(范围1 - 10天)。

结论

腹腔镜阑尾切除术是一种安全、发病率低的手术。对肥胖患者、合并其他病变的患者以及阑尾位置异常的患者具有优势,且感染率低。

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