Lee Chien-Hsing, Lin Yu-Li
Division of Pediatric Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
Int Surg. 2003 Apr-Jun;88(2):92-4.
Laparoscopic appendectomy (LA) is a commonly performed procedure that is a safe alternative to conventional open appendectomy (OA). LA offers reduced parietal scarring, a shortened hospital stay, and an earlier return to normal activities. During a 13-month period (July 2001 to July 2002), data were collected regarding appendectomies performed in 113 children (<18 years) in our hospital. Patients were divided into two groups according to type of appendectomy received (OA, N = 59 versus LA, N = 54). The operative time, length of hospital stay, and postoperative complications were compared between the two groups. Operative time was similar in the OA and LA groups (1.20 +/- 0.46 versus 1.12 +/- 0.36 hours, respectively; P = 0.328). Patients receiving OA had significantly longer hospital stays than those receiving LA (4.69 +/- 3.45 versus 3.07 +/- 1.93 days, respectively; P = 0.002). The complication rate associated with OA was higher than that observed for LA (6.8% versus 3.5%), but this difference was not significant (P = 0.681). Patients receiving LA could begin drinking water earlier after surgery than postflatus OA patients (12-24 hours versus 3.2 days). The OA group had a higher rate of ruptured appendicitis than the LA group (13/59 versus 2/54), but similar rates of normal appendix was observed in both groups (13/59 versus 13/54). Three patients in the LA group were switched to OA. Although patients who underwent LA did not experience a significant decrease in complications compared with OA patients, they did have shorter hospital stays and postoperative NPO times. Therefore, LA seems to be a safe operation in children. It is ideal for overweight, adolescent females and patients in whom appendicitis is suspected. LA is not recommended for those with an appendiceal mass.
腹腔镜阑尾切除术（LA）是一种常见的手术，是传统开放性阑尾切除术（OA）的安全替代方法。LA可减少腹壁瘢痕形成，缩短住院时间，并能更早恢复正常活动。在13个月期间（2001年7月至2002年7月），收集了我院113名18岁以下儿童阑尾切除术的数据。根据接受的阑尾切除术类型将患者分为两组（OA组，n = 59；LA组，n = 54）。比较两组的手术时间、住院时间和术后并发症。OA组和LA组的手术时间相似（分别为1.20±0.46小时和1.12±0.36小时；P = 0.328）。接受OA的患者住院时间明显长于接受LA的患者（分别为4.69±3.45天和3.07±1.93天；P = 0.002）。与OA相关的并发症发生率高于LA（6.8%对3.5%），但差异无统计学意义（P = 0.681）。接受LA的患者术后比排气后接受OA的患者更早开始饮水（12 - 24小时对3.2天）。OA组阑尾破裂率高于LA组（13/59对2/54），但两组正常阑尾的发生率相似（13/59对13/54）。LA组有3例患者转为OA手术。虽然与OA患者相比，接受LA的患者并发症没有显著减少，但他们的住院时间和术后禁食时间较短。因此，LA似乎是儿童的一种安全手术。它适用于超重、青春期女性以及疑似阑尾炎的患者。不推荐对阑尾有包块的患者进行LA手术。
