Aydogan Fatih, Saribeyoglu Kaya, Simsek Osman, Salihoglu Ziya, Carkman Sinan, Salihoglu Tamer, Karatas Adem, Baca Bilgi, Kucuk Ozan, Yavuz Nihat, Pekmezci Salih
Department of General Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
J Laparoendosc Adv Surg Tech A. 2009 Jun;19(3):375-8. doi: 10.1089/lap.2008.0368.
Various techniques have been used for the division of mesoappendix, such as endoloops, endoscopic linear cutting staplers, an electrothermal vessel-sealing system (LigaSure), the Harmonic Scalpel, clips, and bipolar coagulation. In the present study, LigaSure and an endoclip were compared in laparoscopic appendectomy (LA).
This study included patients who underwent LA for acute appendicitis at Istanbul University, Cerrahpasa Medical Faculty, Emergency Unit (Istanbul, Turkey) between May 2003 and April 2007. The patients were assigned to two groups according to the mesoappendix dissection device: LigaSure and endoclip groups. The main outcome measures (e.g., operating time, conversion rate, hospital stay, postoperative complications, etc.) were then compared.
LA was performed in 280 patients with acute appendicitis. LigaSure and endoclips were used in 127 and 153 patients, respectively. The mean operative times were 41 and 54 minutes in the LigaSure and endoclip groups, respectively. Conversions to open rates were found to be 9.4% (12 patients) in the LigaSure and 11.1% (17 patients) in endoclip groups. No statistically significant differences regarding hospital stay or complications were found, whereas significant differences were observed in surgical time and conversion rate.
The use of LigaSure facilitates the dissection of mesoappendix and shortens the operation time in LA. We believe that LigaSure is a safe, useful tool for mesoappendix dissection.
已采用多种技术来分离阑尾系膜，如内镜圈套器、内镜直线切割吻合器、电热血管闭合系统（LigaSure）、超声刀、钛夹和双极电凝。在本研究中，对LigaSure和内镜钛夹在腹腔镜阑尾切除术（LA）中的应用进行了比较。
本研究纳入了2003年5月至2007年4月在土耳其伊斯坦布尔大学塞拉哈帕夏医学院急诊科因急性阑尾炎接受LA的患者。根据阑尾系膜分离器械将患者分为两组：LigaSure组和内镜钛夹组。然后比较主要结局指标（如手术时间、中转率、住院时间、术后并发症等）。
280例急性阑尾炎患者接受了LA。LigaSure组和内镜钛夹组分别有127例和153例患者。LigaSure组和内镜钛夹组的平均手术时间分别为41分钟和54分钟。LigaSure组的中转开腹率为9.4%（12例患者），内镜钛夹组为11.1%（17例患者）。在住院时间或并发症方面未发现统计学显著差异，而在手术时间和中转率方面观察到显著差异。
LigaSure的使用有助于阑尾系膜的分离，并缩短LA的手术时间。我们认为LigaSure是一种用于阑尾系膜分离的安全、有用的工具。
