腹腔镜阑尾切除术中吻合技术及阑尾系膜处理的比较
Comparison of stapling techniques and management of the mesoappendix in laparoscopic appendectomy.
作者信息
Wright G Paul, Mitchell Eric J, McClure Amanda M, Onesti Jill K, Moyo Steven C, Brown Alexander R, Peshkepija Andi, Scott Geoffrey L, Chung Mathew H
机构信息
Grand Rapids Medical Education Partners General Surgery Residency Program Michigan State University College of Human Medicine Spectrum Health Medical Group, Department of Surgical Specialties, Grand Rapids, MI.
出版信息
Surg Laparosc Endosc Percutan Tech. 2015 Feb;25(1):e11-e15. doi: 10.1097/SLE.0000000000000040.
Many techniques for laparoscopic appendectomy have been proposed with few comparative studies. We performed a retrospective review of all patients undergoing laparoscopic appendectomy for uncomplicated appendicitis from 2006 to 2011. Techniques were: (1) transection of the mesoappendix and appendix with a single staple line (SSL); (2) transection of the mesoappendix and appendix with multiple staple lines (MSL); and (3) transection of the mesoappendix with ultrasonic shears and the appendix with a single staple line (USSL). A total of 565 cases were reviewed (149 SSL, 259 MSL, and 157 USSL). Patients treated with the SSL technique had decreased operative duration (P<0.001) and length of stay (P=0.003) despite equivalent disease presentations. Multivariate analysis demonstrated decreased operative duration with the SSL technique (P=0.001). Use of a SSL for transection of the mesoappendix and appendix is both a safe and efficient technique that results in reduced operative duration with excellent surgical outcomes.
虽然已提出多种腹腔镜阑尾切除术技术，但比较研究较少。我们对2006年至2011年期间因单纯性阑尾炎接受腹腔镜阑尾切除术的所有患者进行了回顾性研究。手术技术包括：（1）用单排吻合器横断阑尾系膜和阑尾（SSL）；（2）用多排吻合器横断阑尾系膜和阑尾（MSL）；（3）用超声刀横断阑尾系膜，用单排吻合器横断阑尾（USSL）。共回顾了565例病例（149例SSL、259例MSL和157例USSL）。尽管疾病表现相同，但采用SSL技术治疗的患者手术时间缩短（P<0.001），住院时间缩短（P=0.003）。多因素分析显示，SSL技术可缩短手术时间（P=0.001）。使用单排吻合器横断阑尾系膜和阑尾是一种安全有效的技术，可缩短手术时间并获得良好的手术效果。
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