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开放手术与腹腔镜阑尾切除术的疗效比较:一项回顾性队列研究。

Comparison of outcomes of open and laparoscopic appendectomy: A retrospective cohort study.

作者信息

Basukala Sunil, Thapa Niranjan, Bhusal Ujwal, Shrestha Oshan, Karki Sagun, Regmi Shiva K, Shah Kunda B, Shah Aasish

机构信息

Department of Surgery Nepalese Army Institute of Health Sciences Kathmandu Nepal.

College of Medicine, Nepalese Army Institute of Health Sciences Kathmandu Nepal.

出版信息

Health Sci Rep. 2023 Aug 3;6(8):e1483. doi: 10.1002/hsr2.1483. eCollection 2023 Aug.

Abstract

BACKGROUND

Open appendectomy has been the conventional choice of treatment for acute appendicitis. However, nowadays laparoscopic approach is emerging for the benefits it provides, like lesser postoperative pain and lesser duration of hospital stay, but at the cost of higher expenses and longer operative duration.

METHODS

A retrospective cohort study was done at Shree Birendra Hospital from January 2018 to December 2021, with a total study population of 450 participants (300 in open appendectomy and 150 in laparoscopic appendectomy). Preoperative. Intraoperative and postoperative parameters were compared and analyzed between two groups using SPSS-25.

RESULTS

The mean age was 26.72 ± 9.70 in the open appendectomy (OA) and years 23.89 ± 6.32 in the laparoscopic appendectomy (LA) group. ( = 0.010) There was a significant difference between the mean operative time (46.08 ± 13.10 min in OA and 56.86 ±  11.70 min in LA,  = 0.000), length of hospital stay (1.28 ± 0.80 days in OA and 1.07 ±  0.25 days in LA,  = 0.000), course of oral analgesics (3.55 ± 0.68 days in OA and 3.00 days in LA  = 0.000) between OA groups and LA groups, while the total number of complications was less in the LA group however there was no statistically significant difference postoperative complications ( = 0.124) between the two groups in the surgical findings.

CONCLUSION

All in all, the laparoscopic approach is a better option for uncomplicated appendicitis due to its less postoperative pain and shorter duration of hospital stay.

摘要

背景

开放性阑尾切除术一直是急性阑尾炎的传统治疗选择。然而,如今腹腔镜手术方法因其带来的益处而兴起,比如术后疼痛较轻、住院时间较短,但代价是费用较高且手术时间较长。

方法

2018年1月至2021年12月在什里·比伦德拉医院进行了一项回顾性队列研究,总研究人群为450名参与者(300例行开放性阑尾切除术,150例行腹腔镜阑尾切除术)。使用SPSS - 25对两组患者的术前、术中和术后参数进行比较和分析。

结果

开放性阑尾切除术(OA)组的平均年龄为26.72±9.70岁,腹腔镜阑尾切除术(LA)组为23.89±6.32岁(P = 0.010)。平均手术时间存在显著差异(OA组为46.08±13.10分钟,LA组为56.86±11.70分钟,P = 0.000),住院时间(OA组为1.28±0.80天,LA组为1.07±0.25天,P = 0.000),口服镇痛药疗程(OA组为3.55±0.68天,LA组为3.00天,P = 0.000),而LA组的并发症总数较少,不过两组手术结果的术后并发症无统计学显著差异(P = 0.124)。

结论

总体而言,腹腔镜手术方法是单纯性阑尾炎的更好选择,因为其术后疼痛较轻且住院时间较短。

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Laparoscopic versus open surgery for suspected appendicitis.腹腔镜手术与开放手术治疗疑似阑尾炎
Cochrane Database Syst Rev. 2018 Nov 28;11(11):CD001546. doi: 10.1002/14651858.CD001546.pub4.

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