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穿孔性阑尾炎的开腹阑尾切除术与腹腔镜阑尾切除术的比较

Comparison of Open Appendectomy and Laparoscopic Appendectomy in Perforated Appendicitis.

作者信息

Nazir Aamna, Farooqi Sarosh Afzal, Chaudhary Noman A, Bhatti Hamza Waqar, Waqar Mahnoor, Sadiq Abdullah

机构信息

Surgery, Holy Family Hospital, Rawalpindi, PAK.

Surgery, Rawalpindi Medical University, Rawalpindi, PAK.

出版信息

Cureus. 2019 Jul 9;11(7):e5105. doi: 10.7759/cureus.5105.

Abstract

Introduction Laparoscopic appendectomy for nonperforated appendicitis is associated with improved outcomes. This study compares laparoscopic appendectomy and open appendectomy in cases of a perforated appendix by assessing surgical site infection, mean operating time, and length of hospital stay. Materials and methods This study was a prospective randomized study conducted at the Department of Surgery, Holy Family Hospital, Rawalpindi, Pakistan, from January 2016 to January 2017, by randomly allotting the laparoscopic or the open appendectomy technique to 130 patients by the lottery method. Patients having a perforated appendix were included after they provided informed consent. Data were entered and analyzed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, NY, US). Results The frequency of wound site infection was significantly higher in open appendectomy (27.69%) than in the laparoscopic approach (10.77%; p=0.01). Mean hospital stay was slightly longer in the laparoscopic approach (4.38 ± 1.09 days) than in open appendectomy (4.18 ± 0.77 days; p=0.23). Mean operating time for laparoscopic appendectomy and open appendectomy was 46.98 ± 2.99 minutes and 53.02 ± 2.88 minutes, respectively (p<0.000). Conclusion Laparoscopic appendectomy was associated with fewer surgical site infections and shorter mean operating time than an open appendectomy.

摘要

引言 腹腔镜阑尾切除术治疗非穿孔性阑尾炎可改善治疗效果。本研究通过评估手术部位感染、平均手术时间和住院时间,比较腹腔镜阑尾切除术和开腹阑尾切除术治疗穿孔性阑尾炎的效果。

材料与方法 本研究为前瞻性随机研究,于2016年1月至2017年1月在巴基斯坦拉瓦尔品第圣家医院外科进行,采用抽签法将130例患者随机分配至腹腔镜或开腹阑尾切除技术组。穿孔性阑尾炎患者在签署知情同意书后纳入研究。使用IBM SPSS Statistics for Windows 20.0版(美国纽约州阿蒙克市IBM公司)录入和分析数据。

结果 开腹阑尾切除术的伤口部位感染发生率(27.69%)显著高于腹腔镜手术(10.77%;p=0.01)。腹腔镜手术的平均住院时间(4.38±1.09天)略长于开腹阑尾切除术(4.18±0.77天;p=0.23)。腹腔镜阑尾切除术和开腹阑尾切除术的平均手术时间分别为46.98±2.99分钟和53.02±2.88分钟(p<0.000)。

结论 与开腹阑尾切除术相比,腹腔镜阑尾切除术的手术部位感染较少,平均手术时间较短。

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