Jiang X, Meng H B, Zhou D L, Ding W X, Lu L S
Shanghai 10th People's Hospital, China.
Ann R Coll Surg Engl. 2013 Oct;95(7):468-72. doi: 10.1308/003588413X13629960049397.
Appendicectomy is the most common surgical procedure performed in general surgery. This study aimed to compare the outcomes of open appendicectomy (OA), laparoscopic appendicectomy (LA) and single port laparoscopic appendicectomy (SPLA).
Fifty consecutive patients with suspected acute appendicitis were studied (OA: n=20, LA: n=20, SPLA: n=10). Clinical outcomes were compared between the three groups in terms of operative time, blood loss, postoperative complications, length of hospital stay and cost.
Patient demographics were similar among groups (p>0.05). SPLA was characterised by longer operative time (88.1 minutes vs 35.6 minutes in OA and 33.4 minutes in LA) and higher costs (12.84 thousand Chinese yuan [RMB] vs 8.41 thousand RMB in LA and 4.99 thousand RMB in OA). OA was characterised by more blood loss (9.8ml vs 7.5ml in SPLA and 6.8ml in LA), longer hospital stay (7.5 days vs 3.5 days in LA and 3.4 days in SPLA) and lower costs. The total number of complications was higher for OA (n=2) than for LA and SPLA (n=0) although this was not statistically significant.
Where feasible, LA should be undertaken as the initial treatment of choice for most cases of suspected appendicitis.
阑尾切除术是普通外科最常见的手术。本研究旨在比较开腹阑尾切除术（OA）、腹腔镜阑尾切除术（LA）和单孔腹腔镜阑尾切除术（SPLA）的疗效。
对连续50例疑似急性阑尾炎患者进行研究（OA组：n = 20，LA组：n = 20，SPLA组：n = 10）。比较三组患者的手术时间、失血量、术后并发症、住院时间和费用等临床结局。
各组患者的人口统计学特征相似（p>0.05）。SPLA的特点是手术时间较长（88.1分钟，而OA为35.6分钟，LA为33.4分钟）且费用较高（1.284万元人民币，而LA为0.841万元人民币，OA为0.499万元人民币）。OA的特点是失血量较多（9.8ml，而SPLA为7.5ml，LA为6.8ml）、住院时间较长（7.5天，而LA为3.5天，SPLA为3.4天）且费用较低。OA的并发症总数（n = 2）高于LA和SPLA（n = 0），尽管差异无统计学意义。
在可行的情况下，LA应作为大多数疑似阑尾炎病例的首选初始治疗方法。
