Choksuwattanasakul Manwat
Department of Obstetrics and Gynecology, Chokchai Hospital, Nakhonratchasima Province, Thailand.
J Obstet Gynaecol Res. 2017 Dec;43(12):1863-1869. doi: 10.1111/jog.13458. Epub 2017 Sep 11.
We aimed to determine the success rate of incidental appendectomy during post-partum sterilization (PPS) using the Chokchai technique and to compare the postoperative morbidity between patients who underwent this procedure with those who underwent simple PPS.
Appendectomy during PPS was performed in 141 patients from 1 May 2012 to 30 April 2014. The control group consisted of 182 simple PPS patients. Primary outcomes were the success rate of the procedure and secondary outcomes were postoperative morbidity and complications.
The success rate of this procedure was 98.6%. There was no statistically significant difference in intraoperative blood loss, hospital length of stay, or postoperative morbidity. Appendectomy added 7.5 min to the total procedure. Intravenous sedation requirements were 13.7% and 33.3% in the control and study groups, respectively. Pathologic evaluation of resected appendices revealed 15 abnormalities (10.8%), including two cases of periappendicitis (1.4%).
When carried out by experienced surgeons and with appropriate anesthesia, incidental appendectomy during PPS is safe. The Chokchai technique (approach through a small periumbilical incision) achieved a high success rate and resulted in minimal scar. Incidental appendectomy not only prevents any future appendicitis but also helps to detect periappendicitis and treat its primary cause. However, this is an option for only selected patients who are clearly informed about the possible risks and benefits of the procedure.
我们旨在确定采用乔猜技术在产后绝育术(PPS)期间进行附带阑尾切除术的成功率,并比较接受该手术的患者与接受单纯PPS患者的术后发病率。
2012年5月1日至2014年4月30日期间,对141例患者在PPS期间进行了阑尾切除术。对照组由182例单纯PPS患者组成。主要结局是手术成功率,次要结局是术后发病率和并发症。
该手术的成功率为98.6%。术中失血量、住院时间或术后发病率无统计学显著差异。阑尾切除术使总手术时间增加了7.5分钟。对照组和研究组的静脉镇静需求分别为13.7%和33.3%。切除阑尾的病理评估显示15例异常(10.8%),包括2例阑尾周围炎(1.4%)。
由经验丰富的外科医生并在适当麻醉下进行时,PPS期间的附带阑尾切除术是安全的。乔猜技术(通过脐周小切口入路)成功率高且瘢痕最小。附带阑尾切除术不仅可预防未来的阑尾炎,还有助于发现阑尾周围炎并治疗其病因。然而,这仅适用于已清楚了解该手术可能风险和益处的特定患者。