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单切口腹腔镜手术在复杂性阑尾炎患者阑尾切除术中的应用。

Application of single incision laparoscopic surgery for appendectomies in patients with complicated appendicitis.

作者信息

Kang Kyung Chae, Lee Seok Youn, Kang Dong Baek, Kim Seung Ho, Oh Jung Taek, Choi Duk Hwa, Park Won Cheol, Lee Jeong Kyun

机构信息

Department of Surgery, Digestive Disease Research Institute and Institute of Medical Science, Wonkwang University College of Medicine, Iksan, Korea.

出版信息

J Korean Soc Coloproctol. 2010 Dec;26(6):388-94. doi: 10.3393/jksc.2010.26.6.388. Epub 2010 Dec 31.

Abstract

PURPOSE

Recently, single incision laparoscopic surgery (SILS) has been studied for its being less invasive surgery and having cosmetic improvement. We investigated the application of SILS for an appendectomy (SILS-A) in cases of complicated appendicitis and compare it with a conventional laparoscopic appendectomy (C-LA).

METHODS

This study involved a total of 40 patients who underwent C-LA or SILS-A in patients with complicated appendicitis; 25 patients received a C-LA, and the other 15 patients received a SILS-A. The clinical outcomes and cosmetic results were compared between the groups.

RESULTS

The SILS-A procedures were performed successfully in patients with complicated appendicitis, but 6 patients who underwent SILS-A needed an additional port for dissection and drainage. Clinical outcomes and postoperative complications were similar in both study groups. The SILS-A group showed significantly higher numbers of pain control than the C-LA group, and the one port SLLS-A group showed significantly better cosmetic result than the C-LA group.

CONCLUSION

SILS-A is technically feasible and safe in patients with complicated appendicitis. However, SILS-A has more postoperative pain than C-LA, and more active pain control should be considered for patients undergoing SILS-A.

摘要

目的

近来,单切口腹腔镜手术(SILS)因其创伤小及美容效果好而受到研究。我们研究了SILS在复杂性阑尾炎阑尾切除术(SILS-A)中的应用,并将其与传统腹腔镜阑尾切除术(C-LA)进行比较。

方法

本研究共纳入40例复杂性阑尾炎患者,其中25例行C-LA,另外15例行SILS-A。比较两组的临床结局及美容效果。

结果

SILS-A手术在复杂性阑尾炎患者中成功实施,但6例接受SILS-A的患者需要额外增加一个切口用于分离和引流。两组的临床结局及术后并发症相似。SILS-A组的疼痛控制次数显著多于C-LA组,单切口SILS-A组的美容效果显著优于C-LA组。

结论

SILS-A在复杂性阑尾炎患者中技术上可行且安全。然而,SILS-A术后疼痛比C-LA更多,对于接受SILS-A的患者应考虑更积极的疼痛控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/3017973/e65285038fb4/jksc-26-388-g001.jpg

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