一项关于腹腔镜治疗肠套叠期间意外阑尾切除术的回顾性研究。
A retrospective study about incidental appendectomy during the laparoscopic treatment of intussusception.
作者信息
Liu Tao, Wu Yibo, Xu Weijue, Liu Jiangbin, Sheng Qingfeng, Lv Zhibao
机构信息
Department of General Surgery, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
出版信息
Front Pediatr. 2022 Sep 6;10:966839. doi: 10.3389/fped.2022.966839. eCollection 2022.
PURPOSE
We aim to see incidental appendectomy (IA) was worth or not during the laparoscopic treatment of intussusception.
METHODS
This study included forty-eight patients who underwent a laparoscopic procedure for idiopathic intussusception without intestinal resection between April 2014 and April 2021. The Chi-square or Fisher's exact tests for categorical variables and the Student -test for continuous variables were used to analyze and compare patient characteristics.
RESULTS
IA was performed on 63% (30/48) of patients after surgical reduction, while 18 (37%), did not. Patients who underwent IA had a higher total cost (16,618 ± 2,174 vs.14,301 ± 5,206, = 0.036), and a longer mean operation duration (59 ± 19 vs.45 ± 21, = 0.025). The distribution of the PO time, length of hospital stay, PCs, and RI did not differ significantly. The histopathological evaluation of the 30 resected appendices revealed five (17%) with signs of acute inflammation, 20 (66%) with chronic signs of inflammation, and five (17%) with inconspicuous appendices.
CONCLUSION
IA is linked to a longer average operation time and a higher total cost. There is insufficient evidence to recommend IA during laparoscopic intussusception treatment. The risks and benefits of IA need further study.
目的
我们旨在探讨在腹腔镜治疗肠套叠过程中进行阑尾切除术（IA）是否值得。
方法
本研究纳入了2014年4月至2021年4月期间48例接受腹腔镜手术治疗特发性肠套叠且未行肠切除的患者。分类变量采用卡方检验或Fisher精确检验，连续变量采用Student检验来分析和比较患者特征。
结果
手术复位后，63%（30/48）的患者接受了IA，而18例（37%）未接受。接受IA的患者总费用更高（16,618±2,174 vs.14,301±5,206，P = 0.036），平均手术时间更长（59±19 vs.45±21，P = 0.025）。术后首次排气时间、住院时间、并发症和复发率的分布差异无统计学意义。对30例切除阑尾的组织病理学评估显示，5例（17%）有急性炎症迹象，20例（66%）有慢性炎症迹象，5例（17%）阑尾无明显病变。
结论
IA与更长的平均手术时间和更高的总费用相关。在腹腔镜肠套叠治疗中，尚无足够证据推荐IA。IA的风险和益处需要进一步研究。
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