Spaventa Ibarrola Antonio, Decanini Terán César, Becerril Martínez Guillermo, González Lazzeri Sergio, Menéndez Skertchly Ana, Gaertner Wolff Wolfgang, Arias Gutiérrez Alfonso, Hernández Vera Francisco, Arriola Sánchez Jorge, Golffier Rosete Claudio
Departamento de Cirugía Endoscópica, The American British Cowdray Medical Center I. A. P México, DF.
Rev Gastroenterol Mex. 2006 Jan-Mar;71(1):31-8.
To compare the diagnostic and therapeutic accuracy of laparoscopic appendectomy versus open appendectomy.
Appendectomy is the treatment of choice for acute appendicitis. Open Appendectomy (OA) has its complications rates (10-20%) and negative explorations in young women are about 25-30%. Acute appendicitis has a 3.1% morbidity and with perforation up to 47.2% and a mortality rate less than 1%. Advantages of laparoscopic appendectomy (LA) has been shown in many studies with lower intraoperatory and postoperatory complications, less hospitalization days, lower pain and faster return to daily activities when its compared with OA.
We perform a retrospective and descriptive trial with 1,883 patients with acute appendicitis between January 2000 to September 2004. Patients smaller than 15 years old and with other postoperatory diagnosis were excluded. Ji2 and t Student statistic tests were performed.
We obtained 1,272 patients with acute appendicitis, 49% male and 51% female. LA was performed in 732 patients, 46.1% male and 53.9% female and OA was performed in 541 patients, 52.6% male and 47.3% female. Similar midage patients in both groups. LS was performed in 180 patients with complicated appendicitis and 116 patients by OA. LA was converted to open surgery in 4.5% patients. Morbidity was lower for laparoscopic group with statistical difference. There were no difference in fasting and hospitalization days.
This procedure is a good choice for differential diagnosis overall in young women and complicated appendicitis with lower morbidity than the OA.
比较腹腔镜阑尾切除术与开腹阑尾切除术的诊断及治疗准确性。
阑尾切除术是急性阑尾炎的首选治疗方法。开腹阑尾切除术（OA）有其并发症发生率（10 - 20%），年轻女性的阴性探查率约为25 - 30%。急性阑尾炎的发病率为3.1%，穿孔时高达47.2%，死亡率低于1%。与OA相比，多项研究已表明腹腔镜阑尾切除术（LA）具有术中及术后并发症更低、住院天数更少、疼痛更轻且能更快恢复日常活动等优势。
我们对2000年1月至2004年9月期间1883例急性阑尾炎患者进行了一项回顾性描述性试验。排除15岁以下患者及有其他术后诊断的患者。进行了t检验和F检验。
我们纳入了1272例急性阑尾炎患者，男性占49%，女性占51%。732例患者接受了LA，其中男性占46.1%，女性占53.9%；541例患者接受了OA，其中男性占52.6%，女性占47.3%。两组患者的年龄中位数相似。180例复杂性阑尾炎患者接受了LA，116例接受了OA。4.5%的LA患者转为开腹手术。腹腔镜组的发病率较低，有统计学差异。禁食天数和住院天数无差异。
总体而言，对于年轻女性及复杂性阑尾炎，该手术是鉴别诊断的良好选择，其发病率低于OA。
