Sebastian R T, Philip J, Dutta Roy S, Sebastian V J
Department of Surgery, Fatima Mata Mission Hospital, Kalpetta, Kerala, India.
Int J Surg. 2007 Apr;5(2):86-8. doi: 10.1016/j.ijsu.2006.01.016. Epub 2006 Mar 3.
Appendicectomy in patients with recurrent appendicitis can be difficult due to an adherent and inflamed appendix. We describe the technique and results of subserosal appendicular stripping (SAA). Over a four-year period, 49 patients who were diagnosed with recurrent appendicitis required SAA. They had prior admission for acute appendicitis which resolved with antibiotic treatment. Persistent symptoms necessitated surgery. SAA was necessary in these patients due to an inflamed, adherent appendix with extensive serosal adhesions. The appendix was delivered out from the serosa following retrograde ligation of the appendicular base. The adherent serosa was left intact. Average patient age was 23 years. All had persistent symptoms for more than one week with a history of one or more previous attacks. No surgical complications were observed except transient serosal bleeding in the first case managed by gentle diathermy. We advocate SAA as a modification of appendicectomy in patients with recurrent appendicitis where the appendix is inflamed and adherent.
对于复发性阑尾炎患者，由于阑尾粘连且发炎，阑尾切除术可能会很困难。我们描述了浆膜下阑尾剥离术（SAA）的技术和结果。在四年期间，49例被诊断为复发性阑尾炎的患者需要进行SAA。他们之前因急性阑尾炎入院，经抗生素治疗后病情缓解。持续的症状使得手术成为必要。由于阑尾发炎、粘连且伴有广泛的浆膜粘连，这些患者需要进行SAA。在逆行结扎阑尾根部后，将阑尾从浆膜下取出。粘连的浆膜保持完整。患者平均年龄为23岁。所有患者均有持续症状超过一周，并有一次或多次先前发作的病史。除了第一例通过温和的透热疗法处理的短暂浆膜下出血外，未观察到手术并发症。我们提倡将SAA作为阑尾切除术的一种改良方法，用于治疗阑尾发炎且粘连的复发性阑尾炎患者。
