Chen Yang, Guo Shi-Gang, Fu Xin-Ao, Fan Zong-Qi, Yuan Jie-Qing, Zhang Xiao-Xin, Liu Huan, Liu Zhu, Huang Yong-Shuai, Song Lei
Department of Gastrointestinal Surgery, Chaoyang Central Hospital, China Medical University, Chaoyang 122000, Liaoning Province, China.
Department of Gastrointestinal Surgery, Chaoyang Central Hospital, Postgraduate Training Base of China Medical University and Jinzhou Medical University, Chaoyang 122000, Liaoning Province, China.
World J Gastrointest Surg. 2025 Apr 27;17(4):102607. doi: 10.4240/wjgs.v17.i4.102607.
Single-port laparoscopic appendectomy is an advanced minimally invasive surgery that involves the use of upgraded instruments and equipment. We previously modified single-port laparoscopic appendectomy with needle-type grasping forceps (mSLAN) for patients with simple appendicitis, but the feasibility and safety of our modified procedure need further evaluation in a high-quality clinical study.
To compare the short-term clinical outcomes of mSLAN with those of conventional three-port laparoscopic appendectomy (CLA) for patients with acute uncomplicated appendicitis.
This single-center, single-blind, prospective, randomized controlled trial included patients who underwent emergency laparoscopic appendectomy for acute uncomplicated appendicitis at our center between April 2024 and August 2024. Patients were randomly divided into the mSLAN group or the CLA group computer-generated randomization. The primary endpoint was the 24-hour postoperative visual analog scale (VAS) score, and the secondary endpoints included the operative time, 24-hour postoperative inflammatory response biomarkers (including white blood cells, the neutrophil ratio, interleukin-6, and C-reactive protein), time to first postoperative exhaust, time to first out-of-bed activity, postoperative length of hospital stay, cost of hospitalization, and incidence of postoperative complications.
A total of 72 patients were enrolled and randomly divided into 2 groups: The mSLAN group ( = 36) and the CLA group ( = 36). The 24-hour VAS scores, 24-hour postoperative inflammatory response marker levels, first postoperative exhaust times, first out-of-bed activity times, postoperative lengths of hospital stay, operative times, or hospitalization costs did not significantly differ between the two groups. No postoperative complications, including incision infection or hernia, abdominal abscess or intestinal obstruction, were observed during the 1-month postoperative follow-up in either group.
Compared with the CLA protocol, the mSLAN protocol for acute uncomplicated appendicitis yielded comparable short-term clinical outcomes, with a similar operative time and better cosmetic outcomes, indicating its potential for clinical application and superiority for patients with high cosmetic requirements. Further research is needed to evaluate the long-term outcomes.
单孔腹腔镜阑尾切除术是一种先进的微创手术，需要使用升级的仪器设备。我们之前对单纯性阑尾炎患者采用针型抓钳改良单孔腹腔镜阑尾切除术（mSLAN），但我们改良手术的可行性和安全性需要在高质量的临床研究中进一步评估。
比较mSLAN与传统三孔腹腔镜阑尾切除术（CLA）治疗急性单纯性阑尾炎患者的短期临床疗效。
本单中心、单盲、前瞻性、随机对照试验纳入了2024年4月至2024年8月期间在本中心接受急诊腹腔镜阑尾切除术治疗急性单纯性阑尾炎的患者。患者通过计算机生成随机化被随机分为mSLAN组或CLA组。主要终点是术后24小时视觉模拟量表（VAS）评分，次要终点包括手术时间、术后24小时炎症反应生物标志物（包括白细胞、中性粒细胞比例、白细胞介素-6和C反应蛋白）、首次排气时间、首次下床活动时间、术后住院时间、住院费用以及术后并发症发生率。
共纳入72例患者并随机分为两组：mSLAN组（n = 36）和CLA组（n = 36）。两组间术后24小时VAS评分、术后24小时炎症反应标志物水平、首次排气时间、首次下床活动时间、术后住院时间、手术时间或住院费用均无显著差异。两组在术后1个月的随访中均未观察到术后并发症，包括切口感染或疝、腹腔脓肿或肠梗阻。
与CLA术式相比，mSLAN术式治疗急性单纯性阑尾炎的短期临床疗效相当，手术时间相似且美容效果更佳，表明其具有临床应用潜力，对有高美容需求的患者具有优势。需要进一步研究评估其长期疗效。
