Duyzings J W, Wesdorp R I, Lemmens H A, Greep J M
Chirurg. 1980 Aug;51(8):519-23.
Since 1967, 2480 appendectomies have been performed at the St. Lucas Hospital (Amsterdam) and the St. Annadal Hospital (Maastricht), of which 250 were for perforated appendicitis. A so-called 'combined method' of treatment was used in all these cases: during the operation saline was used to lavage the peritoneal cavity with the patients in the reverse-Trendelenburg position. Antibiotics were left in the peritoneal cavity. No intraperitoneal drainage was performed, but the wound was drained for 5 days. Postoperative treatment consisted of nasogastric suction and parenteral antibiotics for 5 days in combination with anticoagulation. With thus combined approach one death was seen in 250 cases. There were 20 cases of wound infection (8%), 7 pelvic abscesses (2.8%), and 2 retroperitoneal abscesses. No thromboembolic complications were seen because of the use of routine anticoagulation. For 191 patients (77%), total hospitalization was less than 14 days. This method of treatment is compared with recent reports in literature.
自1967年以来，圣卢卡斯医院（阿姆斯特丹）和圣安娜达尔医院（马斯特里赫特）共进行了2480例阑尾切除术，其中250例为穿孔性阑尾炎。所有这些病例均采用了一种所谓的“联合治疗方法”：手术期间，患者处于反向特伦德伦伯卧位，用生理盐水冲洗腹腔。将抗生素留在腹腔内。未进行腹腔引流，但伤口引流5天。术后治疗包括持续胃肠减压、静脉注射抗生素5天并联合抗凝治疗。采用这种联合治疗方法，250例病例中有1例死亡。有20例伤口感染（8%），7例盆腔脓肿（2.8%），2例腹膜后脓肿。由于采用了常规抗凝治疗，未出现血栓栓塞并发症。191例患者（77%）的总住院时间少于14天。该治疗方法与文献中的近期报道进行了比较。
