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开放手术与腹腔镜阑尾切除术:尼日利亚东北部一家教学医院的疗效比较

Open Versus Laparoscopic Appendectomy: A Comparison of Outcome in a Teaching Hospital, Northeast Nigeria.

作者信息

Mba Emmanuel Louis, Guduf Mohammed Ibrahim, Mshelia Nuhu Musa, Babayo Usman Deba, Misauno Michael Ayedima, Wina Felix Markus

机构信息

Department of Surgery, Zenith Medical and Kidney Centre, Abuja, Nigeria.

Department of Surgery, Federal Teaching Hospital, Gombe, Nigeria.

出版信息

J West Afr Coll Surg. 2024 Oct-Dec;14(4):392-395. doi: 10.4103/jwas.jwas_165_23. Epub 2024 Jul 18.

Abstract

BACKGROUND

Appendectomy could be open or laparoscopic. Laparoscopic appendectomy (LA) is gradually gaining ground in Nigeria, but its outcome is not entirely known.

OBJECTIVE

This study compared the outcomes of LA with those of open appendectomy (OA) in terms of the surgical site infection rate, post-operative pain, time to return of bowel sounds, length of hospital stay, return to normal activities and direct cost of treatment.

PATIENTS AND METHODS

This was a prospective randomised study. All patients above 18 years who were diagnosed with acute appendicitis in Federal Teaching Hospital, Gombe, were recruited after adequate counselling and consent obtained over the 18 months of the study.

RESULTS

Forty (40) patients were recruited with 20 on each arm. The average age was 25 years (±) 6 years and M:F was 1:1.9. The rates of surgical site infection and post-operative pain between both methods were not statistically different, while the time to return of bowel sound, the length of hospital stay and the return to normal activity were significantly reduced in LA compared to OA. However, OA was cheaper in terms of direct cost compared to LA.

CONCLUSION

This study showed that LA may be the preferred method when a quicker recovery from treatment is anticipated, provided the patient can afford the direct cost of the procedure.

摘要

背景

阑尾切除术可采用开放手术或腹腔镜手术。腹腔镜阑尾切除术(LA)在尼日利亚正逐渐普及,但其效果尚不完全清楚。

目的

本研究比较了LA与开放阑尾切除术(OA)在手术部位感染率、术后疼痛、肠鸣音恢复时间、住院时间、恢复正常活动情况及治疗直接费用方面的效果。

患者与方法

这是一项前瞻性随机研究。在18个月的研究期间,对所有在贡贝联邦教学医院被诊断为急性阑尾炎且年龄在18岁以上的患者,在获得充分咨询并取得同意后进行招募。

结果

招募了40例患者,每组20例。平均年龄为25岁(±6岁),男女比例为1:1.9。两种手术方法的手术部位感染率和术后疼痛无统计学差异,而与OA相比,LA的肠鸣音恢复时间、住院时间和恢复正常活动时间显著缩短。然而,在直接费用方面,OA比LA便宜。

结论

本研究表明,如果预计患者能从治疗中更快恢复且能承担手术的直接费用,LA可能是首选方法。

相似文献

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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.

本文引用的文献

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Acute appendicitis: what is the gold standard of treatment?急性阑尾炎:治疗的金标准是什么?
World J Gastroenterol. 2013 Dec 21;19(47):8799-807. doi: 10.3748/wjg.v19.i47.8799.

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