Ventham Nicholas T, Dungworth Jessica C, Benzoni Carlo
Department of General Surgery, Victoria Hospital, Kirkaldy, Fife, UK.
Surg Laparosc Endosc Percutan Tech. 2015 Feb;25(1):59-63. doi: 10.1097/SLE.0000000000000017.
Acute appendicitis remains the most common indication for emergency abdominal surgery in the United Kingdom. Although laparoscopic appendicectomy has demonstrable advantages over open appendicectomy, uptake has not been universal. The aims of this study were to describe trends in laparoscopic appendicectomy in a District General Hospital in Scotland.
Retrospective review of appendix histopathology records within NHS Fife between 2003 and 2010. Note review of cases of acute appendicitis managed with laparoscopic appendicectomy was performed. Perioperative variables in perforated and nonperforated appendicitis were compared. A multivariate logistic regression analysis to determine factors associated with developing complications was performed.
Between 2003 and 2010, 237 laparoscopic appendicectomies were performed. The rate of laparoscopic appendicectomy increased from 2.5% in 2003 to 78% in 2010. In 50% of cases, the trainee surgeon was the primary operator. Complications occurred in 9.6% and the mortality rate was 0.4%. No factors on multivariate logistic regression predicted development of complications.
We describe a change in practice towards laparoscopic appendicectomy for the treatment of acute appendicitis over a 7-year period. Furthermore, laparoscopic appendicectomy is associated with acceptable morbidity rates.
在英国，急性阑尾炎仍然是急诊腹部手术最常见的指征。尽管腹腔镜阑尾切除术相较于开腹阑尾切除术具有明显优势，但该术式的采用并不普遍。本研究旨在描述苏格兰一家地区综合医院腹腔镜阑尾切除术的发展趋势。
对2003年至2010年法夫国民保健服务体系内阑尾组织病理学记录进行回顾性分析。对采用腹腔镜阑尾切除术治疗的急性阑尾炎病例进行病历审查。比较穿孔性和非穿孔性阑尾炎的围手术期变量。进行多因素逻辑回归分析以确定与发生并发症相关的因素。
2003年至2010年期间，共进行了237例腹腔镜阑尾切除术。腹腔镜阑尾切除术的比例从2003年的2.5%增至2010年的78%。在50%的病例中，实习外科医生是主刀医生。并发症发生率为9.6%，死亡率为0.4%。多因素逻辑回归分析未发现预测并发症发生的因素。
我们描述了7年间急性阑尾炎治疗中采用腹腔镜阑尾切除术的实践变化。此外，腹腔镜阑尾切除术的发病率在可接受范围内。
