Langer Monica, Safavi Arash, Skarsgard Erik D
Tufts University Pediatric Surgeon Maine Medical Center Portland, Maine.
Department of Surgery University of Arizona Medical Center Tucson, Arizona.
Surg Technol Int. 2013 Sep;23:81-3.
Options for intracorporeal appendiceal stump closure span a variety of techniques including ligation using intra-corporeal knots, extra-corporeal knots, or an endo-loop (EL), closure with endoscopic clips (EC), or endoscopic stapled (ES) closure. The guiding principles are the need for secure, inert closure of the appendiceal base without injury to the appendiceal stump or cecum, with minimal risks of complication attributable to the closure technique. Safety and complication rates, as well as cost data, should guide the techniques used for pediatric laparoscopic appendectomy. Based on the literature available there is not a clear answer as to the best method for closing the appendiceal stump in pediatric patients, with each of the methods described providing safe closure. Many institutions and surgeons may favor a selective approach, with choice of closure determined by the condition of the appendix at laparoscopy.
体内阑尾残端闭合的方法有多种技术，包括使用体内结、体外结或内镜环（EL）进行结扎，用内镜夹（EC）闭合，或内镜吻合器（ES）闭合。指导原则是需要对阑尾根部进行安全、惰性的闭合，而不损伤阑尾残端或盲肠，且闭合技术导致的并发症风险最小。安全性和并发症发生率以及成本数据应指导小儿腹腔镜阑尾切除术所使用的技术。根据现有文献，对于小儿患者阑尾残端的最佳闭合方法尚无明确答案，所描述的每种方法都能提供安全的闭合。许多机构和外科医生可能倾向于采用选择性方法，闭合方式的选择取决于腹腔镜检查时阑尾的状况。
