Cueto J, D'Allemagne B, Vázquez-Frias J A, Gomez S, Delgado F, Trullenque L, Fajardo R, Valencia S, Poggi L, Ballí J, Diaz J, González R, Mansur J H, Franklin M E
Department of Surgery, Hospitals ABC y Angeles Lomas, Mexico City, Mexico.
Surg Endosc. 2006 May;20(5):717-20. doi: 10.1007/s00464-005-0402-4. Epub 2006 Mar 16.
Although laparoscopic appendectomy has some advantages over open appendectomy, some reports do show more postoperative intraabdominal abscesses.
A retrospective review of complicated appendicitis managed surgically by eight surgical groups from six countries was undertaken. Among 3,433 patients with appendicitis, 1,017 (29.5%) had complicated appendicitis, which included perforated or gangrenous appendicitis with or without localized or disseminated peritonitis. There were 74 preoperative abscesses (7.4%) and 5 small bowel obstructions.
One patient died. There were 29 postoperative intraabdominal abscesses (2.8%) and 112 mostly minor complications. Conversion to laparotomy was necessary for 28 patients (2.7%). The surgical time ranged from 32 to 132 min (mean, 62 min), and the hospital stay ranged from 1 to 18 days (mean, 3.5 days).
The morbidity rates, particularly for intraabdominal abscesses, were less for laparoscopic appendectomy in complicated appendicitis than those reported in the literature for open appendectomy, whereas operating times and hospital stays were similar.
尽管腹腔镜阑尾切除术相较于开腹阑尾切除术具有一些优势，但一些报告确实显示术后腹腔内脓肿更多。
对来自六个国家的八个手术团队手术治疗的复杂性阑尾炎进行回顾性研究。在3433例阑尾炎患者中，1017例（29.5%）患有复杂性阑尾炎，包括伴有或不伴有局限性或弥漫性腹膜炎的穿孔性或坏疽性阑尾炎。术前有74例脓肿（7.4%）和5例小肠梗阻。
1例患者死亡。术后有29例腹腔内脓肿（2.8%）和112例大多为轻度的并发症。28例患者（2.7%）需要转为开腹手术。手术时间为32至132分钟（平均62分钟），住院时间为1至18天（平均3.5天）。
在复杂性阑尾炎中，腹腔镜阑尾切除术的发病率，尤其是腹腔内脓肿的发病率，低于文献报道的开腹阑尾切除术，而手术时间和住院时间相似。
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