小儿经脐腹腔镜辅助阑尾切除术与传统腹腔镜阑尾切除术的比较。
Comparison of Transumbilical Laparoscopically Assisted Appendectomy to Conventional Laparoscopic Appendectomy in Children.
作者信息
Karam Paul A, Mohan Arathi, Buta Martin R, Seifarth Federico G
机构信息
*Department of Pediatric Surgery, Cleveland Clinic Children's Hospital, Cleveland Clinic Foundation †School of Medicine, Case Western Reserve University, Cleveland, OH ‡Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
出版信息
Surg Laparosc Endosc Percutan Tech. 2016 Dec;26(6):508-512. doi: 10.1097/SLE.0000000000000334.
PURPOSE
To compare surgical outcomes of children with appendicitis treated with the transumbilical laparoscopically assisted appendectomy (TULAA) versus the conventional 3-port laparoscopic appendectomy (TPLA).
MATERIALS AND METHODS
Retrospective study of pediatric patients with appendicitis treated with TULAA or TPLA between January 2010 and December 2015. Operative time (OT), length of stay, cost, and surgical site infection rate were compared between the 2 groups.
RESULTS
Six hundred twenty-five appendectomies were performed [263 TULAA, 362 TPLA: acute (457), gangrenous (39), and perforated (129)]. TULAA had a shorter OT (median, 40 vs. 67 min; P<0.001), a shorter length of stay (median, 20 vs. 23 h; P<0.001), and a lesser cost (median $6266 vs. $8927; P<0.001). Surgical site infection rate was slightly higher in the TULAA group (6% vs. 4%; P=0.19).
CONCLUSIONS
TULAA had a shorter OT and was less costly than conventional TPLA. TULAA should be considered as the first surgical approach at treating appendicitis in children.
目的
比较经脐腹腔镜辅助阑尾切除术（TULAA）与传统三孔腹腔镜阑尾切除术（TPLA）治疗儿童阑尾炎的手术效果。
材料与方法
对2010年1月至2015年12月期间接受TULAA或TPLA治疗的小儿阑尾炎患者进行回顾性研究。比较两组患者的手术时间（OT）、住院时间、费用和手术部位感染率。
结果
共进行了625例阑尾切除术[263例TULAA，362例TPLA：急性（457例）、坏疽性（39例）和穿孔性（129例）]。TULAA的手术时间较短（中位数，40分钟对67分钟；P<0.001），住院时间较短（中位数，20小时对23小时；P<0.001），费用较低（中位数6266美元对8927美元；P<0.001）。TULAA组的手术部位感染率略高（6%对4%；P=0.19）。
结论
TULAA的手术时间比传统TPLA短，费用更低。TULAA应被视为治疗儿童阑尾炎的首选手术方法。
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