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经脐部切口使用手术手套端口行腹腔镜阑尾切除术:一项单中心回顾性研究

Laparoscopic Appendectomy Using the Surgical-Glove Port Through an Umbilical Incision: A Single-Center Retrospective Study.

作者信息

Que Son Tran, Hieu Hoc Tran, Duc Long Vu, Thanh Tung Tran, Minh Tuan Nguyen, Minh Hue Bui, Van Minh Nguyen, Toan Thang Nguyen

机构信息

Department of Surgery, Hanoi Medical University, Hanoi, VNM.

Department of General Surgery, Bach Mai Hospital, Hanoi, VNM.

出版信息

Cureus. 2022 Apr 26;14(4):e24512. doi: 10.7759/cureus.24512. eCollection 2022 Apr.

Abstract

Background Single-incision laparoscopic appendectomy (SILA) has recently emerged as a promising alternative for the management of acute appendicitis. This study aimed to compare the surgical outcomes of the SILA with those of three laparoscopic appendectomies (TLA) procedures using the existing equipment, the 10-mm laparoscope, and the surgical-glove port method. Methodology Between February 2021 and February 2022, this single-center retrospective study examined 68 patients who underwent laparoscopic appendectomy by a single surgeon. The study excluded patients with severe appendicitis, grade IV-V, following the American Association for the Surgery of Trauma classification. Clinical outcomes were analyzed, including operation time, hospital stay, postoperative pain, and postoperative morbidity. Results There were no statistically significant differences between SILA and TLA patients, respectively, in operation time (37.5 minutes vs. 35 minutes, p = 0.261) and the median duration of hospitalization (three days vs. three days, p = 0.929). There was no difference in the mean visual analog scale score between the two groups on the first day (p = 0.852), second day (p = 0.540), and the day of discharge from the hospital (p = 0.686), as well as return to diet (two days vs. two days, p = 0.053). Two (10%) cases of short-term complications in the SILA group and one (2.1%) case in the TLA group were noted. Conclusions SILA performed through a handmade surgical-glove port is a safe and viable therapy option for mild-to-moderate appendicitis. When the hospital lacks a specialized laparoscopic single-incision surgical system, this technique should be used on patients.

摘要

背景 单孔腹腔镜阑尾切除术(SILA)最近已成为治疗急性阑尾炎的一种有前景的替代方法。本研究旨在使用现有设备、10毫米腹腔镜和手术手套端口法,比较SILA与三种腹腔镜阑尾切除术(TLA)的手术效果。方法 2021年2月至2022年2月期间,这项单中心回顾性研究检查了68例由单一外科医生进行腹腔镜阑尾切除术的患者。根据美国创伤外科协会的分类,该研究排除了患有重度阑尾炎(IV-V级)的患者。分析了临床结果,包括手术时间、住院时间、术后疼痛和术后发病率。结果 SILA组和TLA组患者在手术时间(37.5分钟对35分钟,p = 0.261)和中位住院时间(三天对三天,p = 0.929)方面分别无统计学显著差异。两组在术后第一天(p = 0.852)、第二天(p = 0.540)和出院当天(p = 0.686)的平均视觉模拟评分以及恢复饮食时间(两天对两天,p = 0.053)方面均无差异。SILA组有2例(10%)短期并发症,TLA组有1例(2.1%)。结论 通过手工制作的手术手套端口进行的SILA是治疗轻至中度阑尾炎的一种安全可行的治疗选择。当医院缺乏专门的腹腔镜单孔手术系统时,应将该技术应用于患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c5/9042655/eb8b82d1320d/cureus-0014-00000024512-i01.jpg

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