Mulita Francesk, Plachouri Kerasia-Maria, Liolis Elias, Kehagias Dimitris, Kehagias Ioannis
Department of Surgery, General University Hospital of Patras, Patras, Greece.
Department of Dermatology, General University Hospital of Patras, Patras, Greece.
Wideochir Inne Tech Maloinwazyjne. 2021 Sep;16(3):560-565. doi: 10.5114/wiitm.2021.103942. Epub 2021 Feb 26.
Acute appendicitis (AA) is one of the most common causes of acute abdominal pain seen in emergency departments and appendectomy has been the preferred treatment of this disease for decades. Postoperative intra-abdominal abscess (PIAA) complicates 3% to 25% of appendectomies and the risk is highest following complicated appendicitis. However, the risk for intra-abdominal abscess formation after appendectomy is still a matter of debate.
To evaluate PIAA formation after open appendectomy (OA) and laparoscopic appendectomy (LA), in particular in complicated appendicitis.
From January 2003 to December 2018, records of patients who underwent appendectomy with diagnosis of appendicitis were retrieved from a computer database for analysis.
During the study period, 1809 appendectomies were performed in our institution (939 LAs and 850 OAs). Twenty conversion cases were recorded. There was no difference between the incidences of PIAA (LA, 3.73% (35/939) and OA, 3.41% (29/850); p > 0.05). The incidence of PIAA in those with complicated appendicitis was: LA, 11/212 (5.19%) vs. OA 14/198 (7.07%); p > 0.05.
This retrospective study shows that the technique of appendectomy does not appear to affect the incidence of IAAs either in uncomplicated or in complicated appendicitis. However, laparoscopic appendectomy has the advantages of laparoscopic procedures, such as lower hospital stay and earlier return to activities, and should therefore be preferred for acute appendicitis.
急性阑尾炎(AA)是急诊科急性腹痛最常见的病因之一,几十年来阑尾切除术一直是这种疾病的首选治疗方法。术后腹腔内脓肿(PIAA)使3%至25%的阑尾切除术出现并发症,且在复杂性阑尾炎后风险最高。然而,阑尾切除术后腹腔内脓肿形成的风险仍存在争议。
评估开放阑尾切除术(OA)和腹腔镜阑尾切除术(LA)后PIAA的形成情况,尤其是在复杂性阑尾炎中。
从2003年1月至2018年12月,从计算机数据库中检索诊断为阑尾炎并接受阑尾切除术的患者记录进行分析。
在研究期间,我们机构共进行了1809例阑尾切除术(939例LA和850例OA)。记录了20例中转病例。PIAA的发生率在LA组为3.73%(35/939),OA组为3.41%(29/850),差异无统计学意义(p>0.05)。复杂性阑尾炎患者中PIAA的发生率为:LA组11/212(5.19%),OA组14/198(7.07%),差异无统计学意义(p>0.05)。
这项回顾性研究表明,阑尾切除技术似乎对单纯性或复杂性阑尾炎中IAA的发生率均无影响。然而,腹腔镜阑尾切除术具有腹腔镜手术的优势,如住院时间短和恢复活动早,因此对于急性阑尾炎应优先选择。