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[腹腔镜盲肠楔形切除术]

[Laparoscopic cecal wedge resection].

作者信息

Karaffa Iván, Barra Zoltán, Balog Tamás, Farkas Zita, Bezsilla János

机构信息

Sebészeti Osztály, Borsod-Abaúj-Zemplén Megyei Központi Kórház és Egyetemi Oktatókórház 3521 Miskolc, Nagy László u. 30.

Központi Aneszteziológiai és Intenzív Terápiás Osztály, Borsod-Abaúj-Zemplén Megyei Központi Kórház és Egyetemi Oktatókórház Miskolc.

出版信息

Magy Seb. 2017 Dec;70(4):307-312. doi: 10.1556/1046.70.2017.4.3.

Abstract

INTRODUCTION

Several indications of cecal wedge resection can be found in the literature, but the most common ones are acute appendicitis, appendiceal mucocele and selected cecal polyps.

PURPOSE

We summarize the indications, review the results of laparoscopic cecal wedge resections carried out in our department from 01.01.2010 till 31.12.2016. A case report is presented when cecal resection was carried out for a cecal polyp.

PATIENTS

Between 01.01.2010 and 31.12.2016, 56 patients underwent a laparoscopic cecal wedge resection. The mean age was 42 years (14-83), 28 males and 28 females. In 46 cases, the indication was complicated acute appendicitis, in 6 cases appendiceal mucocele, in the case of four patients endoscopically unresectable benign cecal polyps.

RESULTS

The average operating time was 65 minutes. For the procedure we used two 10 mm and one 5 mm port, the resection was performed by using 45 or 60 mm laparoscopic stapler. In 57.1% of the reviewed cases, abdominal drainage was applied. Conversion was necessary in the case of 3 patients (5.4%), once due to bleeding, twice due to technical problems. Surgical complications occured in 4 patients (7.1%), all of them from the complicated appendicitis group: one of grade I by Clavien-Dindo, 3 of grade III. The reoperation rate was 5.4% (3 patients): reoperation was accounted for an abdominal wall phlegmon, a pericecal abscess, and once the suspicion of abdominal abscess which was not verified. Perioperative death did not occur.

摘要

引言

盲肠楔形切除术的适应证在文献中有多种记载,但最常见的是急性阑尾炎、阑尾黏液囊肿和特定的盲肠息肉。

目的

我们总结了适应证,回顾了2010年1月1日至2016年12月31日在我科进行的腹腔镜盲肠楔形切除术的结果。并呈现了一例因盲肠息肉行盲肠切除术的病例报告。

患者

2010年1月1日至2016年12月31日期间,56例患者接受了腹腔镜盲肠楔形切除术。平均年龄42岁(14 - 83岁),男性28例,女性28例。46例的适应证为复杂性急性阑尾炎,6例为阑尾黏液囊肿,4例为内镜下无法切除的良性盲肠息肉。

结果

平均手术时间为65分钟。手术中我们使用了两个10毫米和一个5毫米的端口,切除采用45或60毫米的腹腔镜吻合器进行。在57.1%的回顾病例中,放置了腹腔引流管。3例患者(5.4%)需要中转开腹,1例因出血,2例因技术问题。4例患者(7.1%)发生手术并发症,均来自复杂性阑尾炎组:根据Clavien - Dindo分级,1例为Ⅰ级,3例为Ⅲ级。再次手术率为5.4%(3例患者):再次手术分别是因为腹壁蜂窝织炎、盲肠周围脓肿,还有一次是怀疑腹腔脓肿但未得到证实。围手术期无死亡病例。

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