Wu Tian-Chong, Lu Qiao, Huang Zhi-Yong, Liang Xio-Hui
Department of Hepatobiliary and Pancreatic Surgery, Shenzhen People's Hospital, Jinan University, Shenzhen, Guangdong Province, China. E-mail.
Saudi Med J. 2017 Nov;38(11):1108-1112. doi: 10.15537/smj.2017.11.20469.
To assess the therapeutic effects of emergency laparoscopic appendectomy (LA) in treating complicated appendicitis (CA) for elderly patients (defined as age 65 years and above). Methods: We conducted a retrospective study of 115 elderly patients with CA who underwent surgical therapy in the Affiliated Huizhou Hospital of Sun Yat-Sun University, Huizhou, Guangdong Province, China between September 2014 and August 2016. Of these, 59 patients consented to open appendectomy (OA), and LA was performed in the other 56 patients. The perioperative and follow-up variables of the 2 groups were analyzed. Results: The operative time in the LA group was longer than the OA group (LA: 70.5±16.0 min versus [vs.] OA: 59.3±12.0 min, p greater than 0.001). The LA group had lower chances of incision infections (LA: 8.9% vs OA: 28.8 %, p=0.007) and shorter hospital stay (LA: 6.1± 2.5 days vs. OA: 9.6±3.5 days, p greater than 0.001). Return to soft diet (LA: 1.4 ± 0.8 days vs OA: 3.0 ± 1.6 days, p greater than 0.001) and time to out of bed (LA: 1.3±0.5 days vs OA: 2.5±0.9 days, p greater than 0.001) was faster in the LA group. The incidence of complications and 30-day readmission rate in the LA group was much lower than the OA group. Conclusion: Emergency LA in treating elderly patients with CA has the advantages of less trauma, definite curative effect, low complication rates, and fast recovery when compared with OA.
评估急诊腹腔镜阑尾切除术(LA)治疗老年患者(定义为年龄65岁及以上)复杂性阑尾炎(CA)的疗效。方法:我们对2014年9月至2016年8月在中国广东省惠州市中山大学附属惠州医院接受手术治疗的115例老年CA患者进行了回顾性研究。其中,59例患者同意行开腹阑尾切除术(OA),另外56例患者接受了LA。分析两组的围手术期和随访变量。结果:LA组的手术时间长于OA组(LA:70.5±16.0分钟对OA:59.3±12.0分钟,p>0.001)。LA组切口感染几率较低(LA:8.9%对OA:28.8%,p=0.007),住院时间较短(LA:6.1±2.5天对OA:9.6±3.5天,p>0.001)。LA组恢复软食时间(LA:1.4±0.8天对OA:3.0±1.6天,p>0.001)和下床时间(LA:1.3±0.5天对OA:2.5±0.9天,p>0.001)更快。LA组并发症发生率和30天再入院率远低于OA组。结论:与OA相比,急诊LA治疗老年CA患者具有创伤小、疗效确切、并发症发生率低和恢复快的优点。