Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, 21561, Egypt.
Petroleum Hospital, Alexandria, Egypt.
Surg Endosc. 2020 Feb;34(2):907-914. doi: 10.1007/s00464-019-06847-2. Epub 2019 May 28.
The advantages of laparoscopic appendectomy did not meet the same acceptance in the setting of perforated appendicitis as in uncomplicated appendicitis in the general surgical community. The aim of this study was to compare the clinical outcome of laparoscopic and open appendectomy in perforating appendicitis.
A randomized controlled study was conducted on 126 patients presenting with perforated appendicitis. Sixty patients were subjected to laparoscopic appendectomy (LA) and 66 patients underwent traditional open appendectomy (OA).
65 (51.6%) patients were female, and 61 (48.4%) patients were male in whom the mean age was 37.6 + 8.5 years. A significant difference was calculated in the domains of postoperative pain, less need for analgesics, hospital stay, and return to daily activities. The mean operative time was shorter in OA 94 ± 10.4 min than LA 120.6 ± 17.7 min. No statistically significant difference between both groups was detected as regard occurrence of intra-abdominal collection.
In view of its clinical outcomes, laparoscopy should be considered in the context of perforated appendicitis. The possibility of intra-abdominal collection should not be a barrier against the widespread practice of this surgical procedure amidst laparoscopic surgeons if adequate precautions are employed.
腹腔镜阑尾切除术在穿孔性阑尾炎中的优势并未像在普通外科中那样在单纯性阑尾炎中得到相同的认可。本研究旨在比较穿孔性阑尾炎中腹腔镜和开腹阑尾切除术的临床效果。
对 126 例穿孔性阑尾炎患者进行了随机对照研究。60 例患者接受腹腔镜阑尾切除术（LA），66 例患者接受传统开腹阑尾切除术（OA）。
65 例（51.6%）为女性，61 例（48.4%）为男性，平均年龄为 37.6±8.5 岁。术后疼痛、对镇痛剂需求减少、住院时间和恢复日常活动方面存在显著差异。OA 的平均手术时间为 94±10.4 分钟，明显短于 LA 的 120.6±17.7 分钟。两组在腹腔内积液的发生方面无统计学差异。
鉴于其临床效果，在穿孔性阑尾炎中应考虑使用腹腔镜。如果采用适当的预防措施，腹腔镜外科医生不应因可能发生腹腔内积液而对该手术方法的广泛应用产生抵触。
