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回盲部切除术与右半结肠切除术治疗复杂性阑尾炎的比较。

Comparison of ileocecal resection and right hemicolectomy in the surgical treatment of complicated appendicitis.

机构信息

Department of General Surgery, Health Sciences University Derince Training and Research Hospital, Kocaeli-Türkiye.

Department of Gastroenteroloji Surgery, Health Sciences University Derince Training and Research Hospital, Kocaeli-Türkiye.

出版信息

Ulus Travma Acil Cerrahi Derg. 2023 Jun;29(6):705-709. doi: 10.14744/tjtes.2023.83357.

Abstract

BACKGROUND

Simple appendectomy with a complicated appendicitis diagnosis could prove difficult, sometimes requiring ex-tended resection. Hence, we aimed to compare two procedures that are preferred for extended resection, ileocecal resection, and right hemicolectomy, in terms of patients' demographic data, preoperative laboratory values (white blood cell [WBC], Neutrophil-to-lymphocyte ratio [N/L], C-reactive protein [CRP]), operation times, postoperative complications, length of hospital stay, and 1-month mortality rates.

METHODS

We retrospectively reviewed patients who underwent extended resection with the diagnosis of complicated appen-dicitis in our clinic from February 2015 to December 2020. We divided the patients into two groups those who underwent right hemicolectomy and those who underwent ileocecal resection.

RESULTS

Among the 55 patients who underwent extended resection with the diagnosis of complicated appendicitis, 32 (58.1%) underwent right hemicolectomy and 23 underwent ileocecal resection (41.8%). The groups did not differ statistically significantly in terms of demographic characteristics, preoperative laboratory values (WBC, N/L, CRP), Clavien-Dindo classification scores, mean hospital stay, or 1-month mortality rates (p>0.005). However, there was a statistically significant difference between the groups in terms of operation time (p<0.001).

CONCLUSION

Ileocecal resection is a safe procedure for patients diagnosed with complicated appendicitis who are scheduled for extended resection.

摘要

背景

简单的阑尾切除术合并复杂的阑尾炎诊断可能会变得困难,有时需要进行扩大切除。因此,我们旨在比较两种常用于扩大切除的手术方法,回盲部切除术和右半结肠切除术,比较其在患者人口统计学数据、术前实验室值(白细胞[WBC]、中性粒细胞与淋巴细胞比值[N/L]、C 反应蛋白[CRP])、手术时间、术后并发症、住院时间和 1 个月死亡率方面的差异。

方法

我们回顾性分析了 2015 年 2 月至 2020 年 12 月在我院行扩大切除术诊断为复杂阑尾炎的患者。我们将患者分为两组,一组行右半结肠切除术,另一组行回盲部切除术。

结果

在 55 例诊断为复杂阑尾炎行扩大切除术的患者中,32 例(58.1%)行右半结肠切除术,23 例行回盲部切除术(41.8%)。两组在人口统计学特征、术前实验室值(WBC、N/L、CRP)、Clavien-Dindo 分类评分、平均住院时间或 1 个月死亡率方面无统计学差异(p>0.005)。然而,两组在手术时间方面存在统计学差异(p<0.001)。

结论

对于诊断为复杂阑尾炎并计划进行扩大切除的患者,回盲部切除术是一种安全的手术方法。

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本文引用的文献

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Preoperative predictor of extensive resection for acute appendicitis.急性阑尾炎广泛切除的术前预测指标。
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