Shanghai Collaborative Innovation Center of Endoscopy, Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 20032, China.
School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, 20092, China.
Surg Endosc. 2024 Oct;38(10):6146-6155. doi: 10.1007/s00464-024-11013-4. Epub 2024 Aug 22.
Transcolonic endoscopic appendectomy (TEA) is rapidly evolving and has been reported as a minimally invasive alternative to appendectomy. We aimed to characterize the feasibility and safety of a novel unassisted single-channel TEA.
We retrospectively investigated 23 patients with appendicitis or appendiceal lesions who underwent TEA from February 2016 to December 2022. We collected clinicopathological characteristics, procedure‑related parameters, and follow‑up data and analyzed the impact of previous abdominal surgery and traction technique.
The mean age was 56.0 years. Of the 23 patients with appendiceal lesions, fourteen patients underwent TEA and nine underwent traction-assisted TEA (T-TEA). Eight patients (34.8%) had previous abdominal surgery. The En bloc resection rate was 95.7%. The mean procedure duration was 91.1 ± 45.5 min, and the mean wound closure time was 29.4 ± 18.6 min. The wounds after endoscopic appendectomy were closed with clips (21.7%) or a combination of clip closure and endoloop reinforcement (78.3%), and the median number of clips was 7 (range, 3-15). Three patients (13.0%) experienced major adverse events, including two delayed perforations (laparoscopic surgery) and one infection (salvage endoscopic suture). During a median follow-up of 23 months, no residual or recurrent lesions were observed, and no recurrence of abdominal pain occurred. There were no significant differences between TEA and T-TEA groups and between patients with and without abdominal surgery groups in each factor.
Unassisted single-channel TEA for patients with appendiceal lesions has favorable short- and long-term outcomes. TEA can safely and effectively treat appendiceal disease in appropriately selected cases.
经结肠内镜阑尾切除术（TEA）正在迅速发展，已被报道为阑尾切除术的一种微创替代方法。我们旨在描述一种新型非辅助单通道 TEA 的可行性和安全性。
我们回顾性调查了 2016 年 2 月至 2022 年 12 月期间因阑尾炎或阑尾病变而行 TEA 的 23 例患者。我们收集了临床病理特征、与手术相关的参数和随访数据，并分析了既往腹部手术和牵引技术的影响。
患者的平均年龄为 56.0 岁。23 例阑尾病变患者中，14 例行 TEA，9 例行牵引辅助 TEA（T-TEA）。8 例（34.8%）有既往腹部手术史。整块切除率为 95.7%。手术平均持续时间为 91.1±45.5min，平均伤口关闭时间为 29.4±18.6min。内镜阑尾切除术后的伤口采用夹闭（21.7%）或夹闭联合内镜套扎加固（78.3%），夹闭的中位数数量为 7 个（范围 3-15 个）。3 例（13.0%）发生严重不良事件，包括 2 例延迟穿孔（腹腔镜手术）和 1 例感染（内镜缝合挽救）。中位随访 23 个月期间，未观察到残留或复发病变，也未出现腹痛复发。TEA 组和 T-TEA 组、有腹部手术史组和无腹部手术史组在各因素之间均无显著差异。
对于阑尾病变患者，非辅助单通道 TEA 具有良好的短期和长期疗效。TEA 可安全有效地治疗适当选择的阑尾疾病。
