Samsonov V T, Ermolov A S, Gulyaev A A, Yartsev P A, Abdulamitov Kh K, Sattarova Z I
Sklifosovsky Research Institute of Emergency Care.
Sklifosovsky Research Institute of Emergency Care; Russian Medical Academy of Continual Professional Education, Moscow, Russia.
Khirurgiia (Mosk). 2017(6):22-27. doi: 10.17116/hirurgia2017622-27.
To analyze videolaparoscopic diagnosis and treatment of abdominal pathology simulating acute appendicitis (AA).
For the period 2008-2015 at Sklifosovsky Research Institute of Emergency Care 2784 patients with suspected AA underwent clinical, laboratory and ultrasonic examination. Depending on survey results patients were divided into 2 groups. Group I included 1352 (48.6%) patients with AA, group II - 1432 (51.4%) patients with suspected AA. All of them underwent videolaparoscopy.
Videolaparoscopy confirmed AA in 1308 (96.7%) patients of group I and 856 (59,8%) patients of group II. In the 1st group 36 (2.7%) patients had pathology simulating AA and 8 (0.6%) patients had not organic changes; in the 2nd group these values were 462 (32.3%) and 114 (7.9%) respectively. Absence of organic changes was explained by functional bowel disorders. In 95 (3.4%) out of 498 (17.9%) patients of both groups with simulating diseases videolaparoscopy was made and in 49 (1.8%) cases indications for laparotomy were established. In 354 (12.7%) patients with simulating diseases and 122 (4.4%) patients without organic changes operations were not carried out.
Videolaparoscopy in patients scheduled for appendectomy or with unclear clinical picture allows to diagnose various forms of AA, simulating diseases and to perform necessary surgery.
分析腹腔镜诊断与治疗模拟急性阑尾炎（AA）的腹部病变。
2008年至2015年期间，斯克里福索夫斯基急救研究所对2784例疑似AA的患者进行了临床、实验室及超声检查。根据检查结果将患者分为两组。第一组包括1352例（48.6%）AA患者，第二组包括1432例（51.4%）疑似AA患者。所有患者均接受了腹腔镜检查。
腹腔镜检查确诊第一组1308例（96.7%）患者为AA，第二组856例（59.8%）患者为AA。第一组中36例（2.7%）患者有模拟AA的病变，8例（0.6%）患者无器质性改变；第二组中这些数值分别为462例（32.3%）和114例（7.9%）。无器质性改变是由功能性肠病引起的。两组中498例（17.9%）模拟疾病患者中有95例（3.4%）接受了腹腔镜检查，49例（1.8%）患者确定了开腹手术指征。354例（12.7%）模拟疾病患者和122例（4.4%）无器质性改变患者未进行手术。
对于计划行阑尾切除术或临床表现不明确的患者，腹腔镜检查可诊断各种形式的AA、模拟疾病并进行必要的手术。
