Ermolov A S, Samsonov V T, Guliaev A A, Abdulamitov Kh K, Titova G P, A Tlibekova M, Radygina M V
N.V. Sklifosovsky Research Institute of Emergency Care, Moscow.
Khirurgiia (Mosk). 2016(2):19-23. doi: 10.17116/hirurgia2016219-23.
To compare results of macroscopic assessment and materials of histological examination of 1635 appendices removed using videolaparoscopy in patients with acute appendicitis. All patients have been treated in N.V.Sklifosovsky Research Institute of Emergency Care for the period from 2002 to 2014.
Intraoperative macroscopic assessment of appendix's inflammatory changes was performed using some conventional signs. Сatarrhal, phlegmonous and gangrenous changes were suspected in 77 (4.7%), 1432 (87.5%) and 126 (7.7%) cases respectively.
Histological examination revealed catarrhal, phlegmonous and gangrenous changes in 86 (5.3%), 1338 (81.8%) and 115 (7.0%) cases respectively. In 65 (4.0%) patients changes were estimated as chronic, 31 (1.9%) patients had not inflammation. Intraoperatively suspected diagnosis of different forms of appendicitis was confirmed by histological survey in 94.1%. Most cases of matched intraoperative and histological diagnosis were observed in case of phlegmonous appendicitis (88.2%). Only 5.9% of patients had not acute inflammation of appendix that may be explained by overdiagnosis and excess of indications for appendectomy.
比较2002年至2014年期间在N.V.斯克利福索夫斯基急救研究所接受治疗的1635例急性阑尾炎患者经腹腔镜切除阑尾的宏观评估结果和组织学检查材料。
采用一些传统体征对阑尾的炎症变化进行术中宏观评估。分别有77例（4.7%）、1432例（87.5%）和126例（7.7%）疑似卡他性、蜂窝织炎性和坏疽性改变。
组织学检查分别显示86例（5.3%）、1338例（81.8%）和115例（7.0%）为卡他性、蜂窝织炎性和坏疽性改变。65例（4.0%）患者的改变被评估为慢性，31例（1.9%）患者无炎症。术中怀疑的不同形式阑尾炎诊断经组织学检查证实的比例为94.1%。蜂窝织炎性阑尾炎病例中，术中与组织学诊断相符的比例最高（88.2%）。仅5.9%的患者阑尾无急性炎症，这可能是由于过度诊断和阑尾切除术指征过多所致。
