Vegunta Ravindra K, Ali Alya, Wallace Lizabeth J, Switzer Diane M, Pearl Richard H
Children's Hospital of Illinois at OSF St. Francis Medical Center, Peoria 61603, USA.
Am Surg. 2004 Mar;70(3):198-201; discussion 201-2.
This is a retrospective outcomes analysis of pediatric open and laparoscopic appendectomy in a children's hospital. One hundred three children underwent appendectomy for appendicitis by two pediatric surgeons from August 1998 to December 2002. Patients were divided into two groups, laparoscopic appendectomy (LAP) and open appendectomy (OAP), and were further subdivided by diagnosis: normal (NL), acute (AA), and ruptured (RA). There were no differences in age, sex, race, or zip codes between groups. Median age was 10 years. In the acute phase, 28 patients underwent OAP and 65 underwent LAP whereas 10 patients underwent interval appendectomy (IA) 6 weeks after percutaneous drainage of established abscesses (eight were LAP vs two OAP). In the remaining patients, the appendix was normal in 17 (18.4%) and ruptured in 24 (25.8%) pathologically. LAP took longer to perform (57 minutes vs 34.5 minutes) at higher cost (3718 dollars vs 1858 dollars) than OAP. Overall complications were lower in the LAP group (17% vs 29%), and LAP for RA had significantly fewer total complications (25% vs 62.5%). Intra-abdominal abscess increased following LAP: 9.2 per cent versus 3.6 per cent. Length of stay was shorter for LAP versus OAP in both AA (2.0 vs 2.5 days) and RA (5.5 vs 7 days).
这是一项针对一家儿童医院小儿开放性和腹腔镜阑尾切除术的回顾性结果分析。1998年8月至2002年12月期间，两名小儿外科医生为103名患有阑尾炎的儿童实施了阑尾切除术。患者被分为两组，即腹腔镜阑尾切除术（LAP）组和开放性阑尾切除术（OAP）组，并根据诊断进一步细分：正常（NL）、急性（AA）和破裂（RA）。两组在年龄、性别、种族或邮政编码方面没有差异。中位年龄为10岁。在急性期，28例患者接受了OAP，65例接受了LAP，而10例患者在经皮引流已形成的脓肿6周后接受了间隔阑尾切除术（IA）（8例为LAP，2例为OAP）。在其余患者中，病理检查显示阑尾正常的有17例（18.4%），破裂的有24例（25.8%）。与OAP相比，LAP手术时间更长（57分钟对34.5分钟），成本更高（3718美元对1858美元）。LAP组的总体并发症较低（17%对29%），RA的LAP总并发症明显较少（25%对62.5%）。LAP后腹腔内脓肿增加：9.2%对3.6%。在AA（2.0天对2.5天）和RA（5.5天对7天）中，LAP的住院时间均比OAP短。
