Han Jeonghee, Kim Hanbaro, Han Sang Hyup, Kang Byung Mo
Department of Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
J Laparoendosc Adv Surg Tech A. 2022 Mar;32(3):330-335. doi: 10.1089/lap.2021.0625. Epub 2021 Nov 9.
Hybrid appendectomy (HA) has the technical advantages of the excellent visual field provided by laparoscopic surgery and is fast and easy similar to open surgery. We aimed to compare the safety and effectiveness of HA with single- and multiport laparoscopic appendectomy (SPLA and MPLA) in pediatric patients with acute appendicitis. This retrospective study compared the short-term operative outcomes between HA, SPLA, and MPLA groups. From January, 2010 to December, 2019, 239 patients aged <12 years who underwent laparoscopic appendectomy for acute appendicitis were included. The primary outcome was the 30-day postoperative complication rate, stratified according to the modified Clavien-Dindo classification. In 239 patients, HA was more frequently performed in patients with a low body mass index (17.42 versus 18.97 kg/m in the SPLA group versus 18.44 kg/m in the MPLA group, = .029) and tended to be more frequently adopted in uncomplicated appendicitis. In uncomplicated appendicitis, the HA group had a significantly shorter operation time than the MPLA group (31.77 versus 40.09 min, < .001), but had a comparable operation duration with the SPLA group. The rate of 30-day postoperative complications was not significantly different between the groups (HA 7.6% versus SPLA 7.8% versus MPLA 5.4%, = .841). The postoperative time to resume water intake was significantly longer in the SPLA group than in the HA and MPLA groups ( = .008). HA showed a short operation time, fast functional recovery, and acceptable postoperative complication rate in patients with uncomplicated appendicitis and can be safely and effectively performed in these patients.
杂交式阑尾切除术(HA)具有腹腔镜手术视野良好的技术优势,且与开放手术一样快速简便。我们旨在比较HA与单孔和多孔腹腔镜阑尾切除术(SPLA和MPLA)在小儿急性阑尾炎患者中的安全性和有效性。这项回顾性研究比较了HA、SPLA和MPLA组的短期手术结果。纳入了2010年1月至2019年12月期间239例年龄<12岁因急性阑尾炎接受腹腔镜阑尾切除术的患者。主要结局是术后30天并发症发生率,根据改良的Clavien-Dindo分类进行分层。在239例患者中,HA在低体重指数患者中更常施行(SPLA组为17.42 vs 18.97kg/m²,MPLA组为18.44kg/m²,P = 0.029),且在单纯性阑尾炎中更常被采用。在单纯性阑尾炎中,HA组的手术时间明显短于MPLA组(31.77 vs 40.09分钟,P < 0.001),但与SPLA组的手术时长相当。各组术后30天并发症发生率无显著差异(HA为7.6%,SPLA为7.8%,MPLA为5.4%,P = 0.841)。SPLA组术后恢复饮水的时间明显长于HA组和MPLA组(P = 0.008)。HA在单纯性阑尾炎患者中手术时间短、功能恢复快且术后并发症发生率可接受,可在这些患者中安全有效地施行。