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经脐单切口腹腔镜在超重/肥胖青少年复杂性阑尾炎治疗中的应用。

Application of transumbilical single-incision laparoscopy in the treatment of complicated appendicitis in overweight/obese adolescents.

机构信息

Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Gulou District, Fuzhou, Fujian Province, 350001, China.

Fuzhou University Affiliated Provincial Hospital, 134 Dongjie Road, Gulou District, Fuzhou, 350001, Fujian Province, China.

出版信息

BMC Pediatr. 2024 Sep 18;24(1):593. doi: 10.1186/s12887-024-05076-4.

Abstract

OBJECTIVE

To investigate the clinical efficacy of transumbilical single-incision laparoscopic surgery in the treatment of complicated appendicitis in overweight/obese adolescents.

METHODS

A retrospective analysis was conducted on the clinical data of 226 adolescent patients with complicated appendicitis who were admitted to our hospital from January 2014 to June 2022. Among them, 102 cases underwent transumbilical single-incision laparoscopic appendectomy as the observation group, and another 124 cases underwent conventional three-port laparoscopic appendectomy as the control group. The surgical time, intraoperative blood loss, duration of incisional pain, postoperative flatus time, length of hospital stay, surgical site infection (SSI), satisfaction with cosmetic result, and occurrence of postoperative complications were compared between the two groups.

RESULTS

Both groups completed the surgery smoothly, and there were no statistically significant differences in gender, age, BMI, duration of illness, white blood cell count, and preoperative CRP value between the two groups (P > 0.05). There were no statistically significant differences in surgical time and intraoperative blood loss between the two groups (P > 0.05). However, the observation group had shorter hospital stays, shorter duration of incisional pain, shorter postoperative time to flatus, and lower overall postoperative complication rates compared to the control group, with statistically significant differences (P < 0.05). The observation group had higher satisfaction with cosmetic result compared to the control group, with statistically significant differences (P < 0.05). Both groups were followed up for one year postoperatively, and there were no occurrences of residual appendicitis or severe adhesive intestinal obstruction.

CONCLUSION

When proficiently mastered, the application of transumbilical single-incision laparoscopy in the treatment of complicated appendicitis in overweight/obese adolescents offers advantages such as minimal trauma, rapid recovery, fewer complications, and improved aesthetic outcomes.

摘要

目的

探讨经脐单切口腹腔镜手术治疗超重/肥胖青少年复杂性阑尾炎的临床疗效。

方法

回顾性分析 2014 年 1 月至 2022 年 6 月我院收治的 226 例复杂性阑尾炎青少年患者的临床资料,其中 102 例行经脐单切口腹腔镜阑尾切除术(观察组),124 例行传统三孔腹腔镜阑尾切除术(对照组)。比较两组患者的手术时间、术中出血量、切口疼痛持续时间、术后肛门排气时间、住院时间、手术部位感染(SSI)、美容效果满意度及术后并发症发生情况。

结果

两组患者均顺利完成手术,两组患者的性别、年龄、BMI、发病时间、白细胞计数、术前 CRP 值比较,差异均无统计学意义(P>0.05)。两组手术时间、术中出血量比较,差异均无统计学意义(P>0.05)。观察组患者的住院时间、切口疼痛持续时间、术后肛门排气时间更短,术后总并发症发生率更低,美容效果满意度更高,差异均有统计学意义(P<0.05)。两组患者术后均随访 1 年,均无残余阑尾炎或严重粘连性肠梗阻发生。

结论

经脐单切口腹腔镜手术治疗超重/肥胖青少年复杂性阑尾炎,当操作熟练时,具有创伤小、恢复快、并发症少、美容效果好等优点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14be/11409603/e76ecc056c17/12887_2024_5076_Fig1_HTML.jpg

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