Ferranti F, Corona F, Siani L M, Stefanuto A, Aguzzi D, Santoro E
Department of General and Mini-invasive Surgery, San Paolo Hospital, Rome, Italy.
G Chir. 2012 Aug-Sep;33(8-9):263-7.
Laparoscopic Appendectomy (LA) is widely performed for the treatment of acute appendicitis. However the use of laparoscopic approach for complicated appendicitis is controversial, in particular because it has been reported an increased risk of postoperative IntraAbdominal Abscess (IAA). The aim of this study was to compare the outcomes of LA versus Open Appendectomy (OA) in the treatment of complicated appendicitis, especially with regard to the incidence of postoperative IAA.
A retrospective study of all patients treated at our institution for complicated appendicitis, from May 2004 to June 2009, was performed. Data collection included demographic characteristics, postoperative complications, conversion rate, and length of hospital stay.
Thirty-eight patients with complicated appendicitis were analysed. Among these, 18 (47,3%) had LA and 20 (52,7%) had OA. There were no statistical differences in characteristics between the two groups. The incidence of postoperative IAA was higher (16,6%), although not statistically significant, in the LA compared with OA group (5%). On the other hand the rate of wound infection was lower (5%) in the LA versus OA (20%).
Our study indicated that LA should be utilised with caution in case of perforated appendicitis, because it is associated with an increased risk of postoperative IAA compared with OA.
腹腔镜阑尾切除术（LA）广泛应用于急性阑尾炎的治疗。然而，腹腔镜手术用于复杂性阑尾炎的治疗存在争议，特别是因为有报道称术后腹腔内脓肿（IAA）的风险增加。本研究的目的是比较LA与开腹阑尾切除术（OA）治疗复杂性阑尾炎的疗效，尤其是术后IAA的发生率。
对2004年5月至2009年6月在我院接受治疗的所有复杂性阑尾炎患者进行回顾性研究。数据收集包括人口统计学特征、术后并发症、中转率和住院时间。
分析了38例复杂性阑尾炎患者。其中，18例（47.3%）接受了LA，20例（52.7%）接受了OA。两组之间的特征无统计学差异。与OA组（5%）相比，LA组术后IAA的发生率更高（16.6%），尽管无统计学意义。另一方面，LA组的伤口感染率（5%）低于OA组（20%）。
我们的研究表明，在阑尾穿孔的情况下，LA应谨慎使用，因为与OA相比，它与术后IAA的风险增加有关。
