DesGroseilliers S, Fortin M, Lokanathan R, Khoury N, Mutch D
Department of Surgery, Centre Hospitalier Val d'Or, Que.
Can J Surg. 1995 Apr;38(2):178-82.
To compare laparoscopic appendectomy (LA) with traditional methods as the primary treatment for acute appendicitis.
A retrospective case series.
A regional, nonuniversity hospital in northwestern Quebec.
Two hundred patients with a clinical diagnosis of acute appendicitis: 100 (43 men, 57 women; mean age 27 years) underwent laparoscopic appendectomy and 100 (67 men, 33 women; mean age 21 years) had an open appendectomy (OA).
LA or OA.
Operating time, rate of conversion to OA, need for analgesia, morbidity and outcome.
LA was successful in 88% of patients. The mean operating time was 50 minutes for LA versus 24 minutes for OA. On average, patients of the LA group had a 1-day decrease in postoperative hospital stay (2.6 versus 3.6 days). The wound infection rate was lower in the LA group (2% versus 12%) as was the intra-abdominal abscess rate (2% versus 6.0%). There were no deaths in either group. The overall morbidity was 4.5% for the LA group and 18% for the OA group. A clear tendency toward a shorter convalescence was seen in the LA group.
LA is a safe and viable treatment alternative for acute appendicitis. Prospective randomized studies are needed to confirm its potential advantages.
比较腹腔镜阑尾切除术（LA）与传统方法作为急性阑尾炎的主要治疗手段。
回顾性病例系列研究。
魁北克西北部的一家地区性非大学医院。
200例临床诊断为急性阑尾炎的患者：100例（43例男性，57例女性；平均年龄27岁）接受了腹腔镜阑尾切除术，100例（67例男性，33例女性；平均年龄21岁）接受了开腹阑尾切除术（OA）。
LA或OA。
手术时间、转为OA的比例、镇痛需求、发病率及结局。
88%的患者LA手术成功。LA的平均手术时间为50分钟，而OA为24分钟。LA组患者术后住院时间平均缩短1天（2.6天对3.6天）。LA组的伤口感染率较低（2%对12%），腹腔内脓肿率也较低（2%对6.0%）。两组均无死亡病例。LA组的总体发病率为4.5%，OA组为18%。LA组有明显的恢复较快的趋势。
LA是急性阑尾炎一种安全可行的治疗选择。需要进行前瞻性随机研究以证实其潜在优势。
