Park Jongkyung, Kwak Huiyong, Kim Sung Geun, Lee Seong
Department of General Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Laparoendosc Adv Surg Tech A. 2012 Mar;22(2):142-5. doi: 10.1089/lap.2011.0253. Epub 2011 Dec 6.
Laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. Since it was first described, laparoscopic appendectomy has been modified various times for reducing pain and improving cosmetic results. Single-port laparoscopic appendectomy (SPLA) may reduce more postoperative trauma and obtain reliable cosmetic results. We compared the safety and feasibility of this technique with those of conventional laparoscopic appendectomy (CLA).
Between November 2008 and July 2009, 104 patients were enrolled in this study. Their diagnoses were performed by computed tomography scan. The demographic findings and surgical outcomes such as operation time, pathology, postoperative pain score, hospital stay, and complications of the SPLA group were analyzed and compared with those of the CLA group.
SPLA was completed in 42 patients, and 62 patients underwent CLA. Mean age was 29.9 years in the CLA group and 23.9 years in the SPLA group. The average body mass index of patients was 23.0 kg/m(2) in the CLA group and 20.5 kg/m(2) in the SPLA group. Mean operation time was 55.8 minutes in the CLA group and 51.7 minutes in the SPLA group. There was no conversion to open appendectomy in both groups. No major complications were encountered in the two groups. The mean postoperative hospital stay was 2.9 days for the CLA group and 2.6 days for the SPLA group. There were no deaths in either group.
SPLA is a safe technique and shows excellent cosmetic results. This is an easy procedure for an experienced laparoscopic surgeon even with conventional laparoscopic instruments. It remains to be evaluated in cases of perforated appendicitis and periappendiceal abscess.
腹腔镜阑尾切除术在治疗急性阑尾炎方面正变得越来越流行。自首次被描述以来，腹腔镜阑尾切除术已多次改进以减轻疼痛并改善美容效果。单孔腹腔镜阑尾切除术（SPLA）可能会减少更多的术后创伤并获得可靠的美容效果。我们比较了该技术与传统腹腔镜阑尾切除术（CLA）的安全性和可行性。
2008年11月至2009年7月，104例患者纳入本研究。通过计算机断层扫描进行诊断。分析SPLA组的人口统计学结果和手术结果，如手术时间、病理、术后疼痛评分、住院时间和并发症，并与CLA组进行比较。
42例患者完成了SPLA，62例患者接受了CLA。CLA组的平均年龄为29.9岁，SPLA组为23.9岁。CLA组患者的平均体重指数为23.0kg/m²，SPLA组为20.5kg/m²。CLA组的平均手术时间为55.8分钟，SPLA组为51.7分钟。两组均未转为开腹阑尾切除术。两组均未发生重大并发症。CLA组的平均术后住院时间为2.9天，SPLA组为2.6天。两组均无死亡病例。
SPLA是一种安全的技术，美容效果极佳。对于有经验的腹腔镜外科医生来说，即使使用传统的腹腔镜器械，这也是一个简单的手术。在阑尾穿孔和阑尾周围脓肿的病例中，仍有待评估。
