Teli Bhavuray, Ravishankar N, Harish S, Vinayak C S
Department of Surgery, JSS Medical College and Hospital, JSS University, Mysore, 570015 Karnataka India.
Indian J Surg. 2013 Oct;75(5):352-5. doi: 10.1007/s12262-012-0500-1. Epub 2012 Apr 21.
Chronic right lower quadrant pain is a common clinical entity and continues to remain a diagnostic and therapeutic problem. Laparoscopy is changing the view regarding exploration in patients with chronic right lower quadrant pain. Of recent, chronic or recurrent right lower quadrant pain is an entity that has generated much interest, hence this study has been undertaken. To study the role of elective laparoscopic appendicectomy for chronic or recurrent right lower quadrant pain. To study the relationship between clinical improvement and histopathological findings of removed appendix. Forty three cases of chronic right lower quadrant pain, who met the inclusion criteria, were included in the clinical study. Three cases were excluded during initial diagnostic laparoscopy because of ovarian cyst. Laparoscopic appendicectomy was performed in 40 cases. In our study amongst 40 (100 %) patients, 36(90 %) patients were relieved of pain completely. Only 4(10 %) patients continued to have persistent right lower quadrant pain. Duration of follow up was 6 months. Postoperative pain scores favour appendicectomy (p < 0.005). There was no association between postoperative pain scores and histopathology findings. There was no mortality in our study. Persistent or recurrent right lower quadrant pain can be treated successfully by elective laparoscopic appendicectomy in properly selected cases. Laparoscopic appendectomy is a feasible and safe procedure. Histopathology of the removed appendix does not contribute to the diagnosis.
慢性右下腹疼痛是一种常见的临床病症,仍然是一个诊断和治疗难题。腹腔镜检查正在改变对慢性右下腹疼痛患者进行探查的观点。近来,慢性或复发性右下腹疼痛这一病症引发了诸多关注,因此开展了本研究。旨在研究选择性腹腔镜阑尾切除术对慢性或复发性右下腹疼痛的作用。旨在研究临床改善情况与切除阑尾的组织病理学 findings 之间的关系。43 例符合纳入标准的慢性右下腹疼痛患者被纳入临床研究。在初始诊断性腹腔镜检查期间,3 例因卵巢囊肿被排除。40 例患者接受了腹腔镜阑尾切除术。在我们的研究中,40 例(100%)患者中,36 例(90%)患者疼痛完全缓解。只有 4 例(10%)患者右下腹仍持续疼痛。随访时间为 6 个月。术后疼痛评分支持阑尾切除术(p<0.005)。术后疼痛评分与组织病理学 findings 之间无关联。我们的研究中无死亡病例。在适当选择的病例中,选择性腹腔镜阑尾切除术可成功治疗持续性或复发性右下腹疼痛。腹腔镜阑尾切除术是一种可行且安全的手术。切除阑尾的组织病理学对诊断无帮助。 (注:原文中“histopathological findings”直译为“组织病理学发现”,在中文语境下表述稍显生硬,可根据上下文灵活调整表述方式,但按照任务要求需保留原文形式。)