单一切口小儿内镜外科（SIPES）阑尾切除术 - 肥胖是禁忌症吗？

Single incision pediatric endosurgery (SIPES) appendectomy--is obesity a contraindication?

机构信息

Division of Pediatric Surgery, Department of Surgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, USA.

出版信息

J Pediatr Surg. 2013 Jun;48(6):1399-404. doi: 10.1016/j.jpedsurg.2013.03.043.

DOI:10.1016/j.jpedsurg.2013.03.043

PMID:23845637

Abstract

INTRODUCTION

Single-incision pediatric endosurgery (SIPES) is gaining popularity and has been reported to be safe in acute (non-perforated) and perforated appendicitis. The feasibility of SIPES appendectomy in obese children is uncertain.

MATERIALS AND METHODS

After IRB approval, data were collected from a prospectively maintained SIPES appendectomy database for cases performed between April 2009 and March 2012. Patients were divided into obese and non-obese groups based on Center for Disease Control criteria. The surgical techniques, operative times, complications, conversion rates, and outcomes were recorded. Chi-square test and t-test were used for statistical analysis.

RESULTS

SIPES appendectomy was attempted in 500 children. There were 21% obese, and 37% were female with median age of 10.9 ± 3.8 years. Mean operative time, blood loss, requirement of additional trocars, and intraoperative complications in non-obese and obese children were not significantly different. Mean hospital stay (2.3 days in each group), post operative wound infections (3.3% vs. 4.8%, p=0.55, non-obese vs. obese), and intraabdominal abscesses (4.3% vs. 2.9%, p=0.77, non-obese vs. obese) were not significantly different.

CONCLUSION

SIPES appendectomy may be accomplished successfully and safely in obese children. Obesity did not appear to be associated with increased risk of complications and was not a contraindication for SIPES appendectomy.

摘要

简介

单切口儿科内镜手术（SIPES）越来越受欢迎，并且已被报道在急性（非穿孔性）和穿孔性阑尾炎中是安全的。SIPES 阑尾切除术在肥胖儿童中的可行性尚不确定。

材料和方法

在获得机构审查委员会批准后，从 2009 年 4 月至 2012 年 3 月期间前瞻性维护的 SIPES 阑尾切除术数据库中收集数据。根据疾病控制中心的标准，将患者分为肥胖组和非肥胖组。记录手术技术、手术时间、并发症、转化率和结果。使用卡方检验和 t 检验进行统计分析。

结果

SIPES 阑尾切除术尝试用于 500 例儿童。肥胖儿童占 21%，女性占 37%，中位年龄为 10.9 ± 3.8 岁。非肥胖和肥胖儿童的平均手术时间、出血量、需要额外的 trocars 以及术中并发症没有明显差异。非肥胖和肥胖儿童的平均住院时间（每组 2.3 天）、术后伤口感染（3.3%与 4.8%，p=0.55，非肥胖与肥胖）和腹腔脓肿（4.3%与 2.9%，p=0.77，非肥胖与肥胖）无显著差异。