Karakus Suleyman Cuneyt, Kilincaslan Huseyin, Koku Naim, Ertaskin Idris
Department of Pediatric Surgery, Gaziantep Children's Hospital, Gaziantep, Turkey.
J Korean Surg Soc. 2013 Aug;85(2):80-3. doi: 10.4174/jkss.2013.85.2.80. Epub 2013 Jul 25.
Since laparoscopic appendectomy was first described, various modifications, such as single port incisionless-intracorporeal conventional equipment-endoscopic surgery (SPICES), have been described for reducing pain and improving cosmetic results. In the retrocecal and retrocolic positions, attachments to the lateral peritoneum and cecum may lead to difficulties during SPICES, which is performed with only one port. Here, we present the effects of variations in the position of the vermiform appendix in treating acute appendicitis with SPICES.
We retrospectively reviewed 52 children who underwent SPICES for acute appendicitis between March 2010 and November 2011 in our institution. One group (group A) consisted of 30 patients (mean age, 10.5 ± 2.5 years) with retrocecal appendix, while the other group (group B) included 22 patients (mean age, 10.9 ± 2.3 years) with the appendix lying free in the peritoneal cavity.
There were no significant differences between groups in terms of patient age, gender, success rate of SPICES, mean operating time, mean follow-up period, overall complication rates or mean postoperative hospitalization period.
These results suggest that SPICES is a safe and feasible approach even in patients with retrocecal acute appendicitis.
自首次描述腹腔镜阑尾切除术以来，已经出现了各种改良方法，如单孔无切口-体内常规设备-内镜手术（SPICES），以减轻疼痛并改善美容效果。在盲肠后和结肠后位置，阑尾与侧腹膜和盲肠的附着可能会导致在仅通过一个端口进行的SPICES手术过程中出现困难。在此，我们展示了阑尾位置变化在SPICES治疗急性阑尾炎中的效果。
我们回顾性分析了2010年3月至2011年11月在我院接受SPICES治疗急性阑尾炎的52例儿童患者。一组（A组）由30例盲肠后阑尾患者组成（平均年龄10.5±2.5岁），另一组（B组）包括22例阑尾位于腹腔内游离状态的患者（平均年龄10.9±2.3岁）。
两组在患者年龄、性别、SPICES成功率、平均手术时间、平均随访期、总体并发症发生率或平均术后住院时间方面均无显著差异。
这些结果表明，即使对于盲肠后急性阑尾炎患者，SPICES也是一种安全可行的方法。
