Cebrián Muíños C, Gómez Farpón A, Granell Suárez C, Vega Mata N, López López A, Alvarez Muñoz V, Martínez-Almoyna Rullán C
Servicio de Cirugía Pediátrica, Hospital Universitario Central de Asturias.
Cir Pediatr. 2011 Apr;24(2):98-101.
There are several different techniques for laparoscopic appendectomy (LA), with different material requirements and approach. We present the results from our series, where we employ monopolar hook for mesoappendix dissection and double polyglactin endoloop for ligation of appendicular stump. The appendix is taken out through the Hasson trocar without any contact with abdominal wall, in a completely laparoscopic procedure. We sought to analyze the security of this technique. We reviewed retrospectively every LA for acute appendicitis performed during the last 10 years in our Hospital. We collected data regarding surgical procedure and postoperative outcome, focusing on intraoperative or postoperative complications. A total of hundred and ten (110) LA for acute appendicitis (from simple appendicitis to perforated appendicitis) were performed. Mean operative time was 74.7 minutes (median 70 min, SD 24.43 min, min. 25, max. 130 min). Ten patients (9.09%) had postoperative complications, consisting in intraabdominal abscess in 6 patients (5.4%) and wound infection in 3 patients (2.7%). No major complication was found, as uncontrolled hemorrhage, bowel perforation or stump dehiscence. No patient needed a second surgical procedure in the postoperative time. Laparoscopic appendectomy with polyglactin endoloops is a completely laparoscopic and safe procedure, without any intraoperative complication in our series. Laparoscopic approach with 12 mm Hasson trocar and two 5 mm working trocars allows a nice aesthetic result.
腹腔镜阑尾切除术(LA)有几种不同的技术,材料要求和手术方法各不相同。我们展示了我们系列研究的结果,在该研究中我们使用单极钩进行阑尾系膜分离,用双聚乙醇酸内套圈结扎阑尾残端。阑尾通过哈森套管针取出,在完全腹腔镜手术过程中不与腹壁接触。我们试图分析该技术的安全性。我们回顾性分析了我院过去10年中进行的每一例急性阑尾炎腹腔镜阑尾切除术。我们收集了有关手术过程和术后结果的数据,重点关注术中或术后并发症。共进行了110例急性阑尾炎腹腔镜阑尾切除术(从单纯性阑尾炎到穿孔性阑尾炎)。平均手术时间为74.7分钟(中位数70分钟,标准差24.43分钟,最短25分钟,最长130分钟)。10例患者(9.09%)出现术后并发症,其中6例(5.4%)发生腹腔内脓肿,3例(2.7%)发生伤口感染。未发现严重并发症,如无法控制的出血、肠穿孔或残端裂开。术后无患者需要二次手术。使用聚乙醇酸内套圈的腹腔镜阑尾切除术是一种完全腹腔镜下的安全手术,在我们的系列研究中无任何术中并发症。采用12mm哈森套管针和两个5mm操作套管针的腹腔镜手术方法可获得良好的美观效果。