无气经脐单切口腹腔镜辅助阑尾切除术的简易技术
Simple technique for gasless transumbilical single-incisional laparoscopic-assisted appendectomy.
作者信息
Ikeda Naoya, Ueno Masato, Kanamura Tetsuhiro, Sho Masayuki, Sasaki Yoshiyuki, Enomoto Koji, Kunishige Tomohiro, Nogi Kazutaka, Kosugi Takaaki, Nakagawa Kenji, Sakaguchi Hiroshi, Hidaka Shoko, Ochi Tomoko, Nakajima Yoshiyuki
机构信息
Department of Surgery, Nara Prefectural Mimuro Hospital, 1-14-16 Mimuro, Sango-cho, Ikoma-gun, Nara, Nara, 636-0802, Japan,
出版信息
Langenbecks Arch Surg. 2014 Mar;399(3):359-66. doi: 10.1007/s00423-014-1164-z. Epub 2014 Jan 22.
PURPOSE
Single-incision laparoscopic surgery has recently received more attention. We developed a novel simple technique of gasless transumbilical single-incisional laparoscopic-assisted appendectomy (TUSILAA) and retrospectively analyzed our initial experience.
METHODS
TUSILAA has been attempted in 50 consecutive patients with acute appendicitis. The vertical incision through the umbilicus was used for laparoscopic access and the abdominal wall was lifted by a Kent retractor set system.
RESULTS
Our technique was successful in 45 out of 50 (90 %) patients. The median operating time was 59 min (range 35-140). The median length of postoperative hospital stay was 4 days (range 2-12). None of the cases were converted to open appendectomy. There were no perioperative surgical complications.
CONCLUSIONS
Our novel technique, gasless TUSILAA, is safe and feasible with acceptable operative time and excellent cosmetic result. Furthermore, this procedure has the advantage of cost-effectiveness since any disposable instruments including trocars, staplers, or expensive devices are not required. Therefore, this could be used as the first-choice surgical procedure for selected patients with uncomplicated acute appendicitis.
目的
单切口腹腔镜手术近来受到更多关注。我们开发了一种新型的简单技术——非气腹经脐单切口腹腔镜辅助阑尾切除术（TUSILAA），并对我们的初步经验进行了回顾性分析。
方法
连续对50例急性阑尾炎患者尝试进行TUSILAA。通过脐部的垂直切口进行腹腔镜入路，使用肯特牵开器系统提起腹壁。
结果
我们的技术在50例患者中的45例（90%）成功实施。中位手术时间为59分钟（范围35 - 140分钟）。术后中位住院时间为4天（范围2 - 12天）。无一例转为开腹阑尾切除术。无围手术期手术并发症。
结论
我们的新技术——非气腹TUSILAA安全可行，手术时间可接受，美容效果良好。此外，该手术具有成本效益优势，因为不需要任何一次性器械，包括套管针、吻合器或昂贵设备。因此，对于选定的单纯性急性阑尾炎患者，这可作为首选手术方式。
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