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腹腔镜二期阑尾切除术治疗阑尾周围脓肿的价值:单中心经验

The value of a laparoscopic interval appendectomy for treatment of a periappendiceal abscess: experience of a single medical center.

作者信息

You Keun-Su, Kim Dae Hoon, Yun Hyo Yung, Jang Lee-Chan, Choi Jeo-Woon, Song Young Jin, Ryu Dong Hee

机构信息

Department of Surgery, Chungbuk National University, College of Medicine and Medical Research Institute, Cheongju, Korea.

出版信息

Surg Laparosc Endosc Percutan Tech. 2012 Apr;22(2):127-30. doi: 10.1097/SLE.0b013e318244ea16.

Abstract

BACKGROUND

Interval appendectomy has been known to be an effective and safe treatment for a periappendiceal abscess, but there is no study on a laparoscopic approach for the treatment of a periappendiceal abscess. The aim of this study is to investigate the value of laparoscopic interval appendectomy.

MATERIALS AND METHODS

We retrospectively studied 56 patients who had been admitted due to a periappendiceal abscess to Chungbuk National University Hospital from July 2005 to June 2010. Fifteen patients underwent an initial conservative treatment and interval appendectomy. Medical records were reviewed for the postoperative hospital course such as complications, time of initiation of diet, time since stopping antibiotics, symptoms' relief period, and length of hospital stay.

RESULTS

All patients received initial conservative treatment [percutaneous drainage insertion (1 case failed) and intravenous antibiotics], and the initial length of hospital stay was 11.6±4.3 days. Percutaneous drainage was removed a mean of 21.7±9.4 days after the initial treatment. Interval appendectomy was performed at a mean of 64.0±17.8 days after initial admission. The duration of use of intravenous antibiotics was a mean of 4.1±1.8 days after laparoscopic interval appendectomy. The complication rate was 1 (6.7%) and the open conversion rate was 1 (6.7%).

CONCLUSIONS

Our study revealed that initial conservative treatment and laparoscopic interval appendectomy represented a feasible and effective treatment for patients with a periappendiceal abscess.

摘要

背景

已知间隔期阑尾切除术是治疗阑尾周围脓肿的一种有效且安全的方法,但尚无关于腹腔镜治疗阑尾周围脓肿的研究。本研究的目的是探讨腹腔镜间隔期阑尾切除术的价值。

材料与方法

我们回顾性研究了2005年7月至2010年6月期间因阑尾周围脓肿入住忠北国立大学医院的56例患者。15例患者接受了初始保守治疗和间隔期阑尾切除术。对术后住院过程进行病历审查,包括并发症、开始进食时间、停用抗生素时间、症状缓解期和住院时间。

结果

所有患者均接受了初始保守治疗[经皮引流置管(1例失败)和静脉使用抗生素],初始住院时间为11.6±4.3天。经皮引流在初始治疗后平均21.7±9.4天拔除。间隔期阑尾切除术在初次入院后平均64.0±17.8天进行。腹腔镜间隔期阑尾切除术后静脉使用抗生素的时间平均为4.1±1.8天。并发症发生率为1例(6.7%),中转开腹率为1例(6.7%)。

结论

我们的研究表明,初始保守治疗和腹腔镜间隔期阑尾切除术是治疗阑尾周围脓肿患者的一种可行且有效的方法。

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