Neal G E, McClintic E C, Williams J S
Department of Surgical Education, Memorial Medical Center, Savannah, GA 31403-3089.
Surg Laparosc Endosc. 1994 Aug;4(4):272-6.
Laparoscopic appendectomy represents another challenge for residency training. This retrospective study was conducted to determine the efficacy of this operation, to contrast it to conventional appendectomy, and to describe experience in teaching residents. We examined the case records of 151 patients who underwent appendectomies performed by residents between September 1990 and September 1992. Surgery was performed laparoscopically in 26% of the cases, by conventional means in 65%, and converted to an open procedure in 9% of the total patients. Acute appendicitis was confirmed in 56% of laparoscopic patients, 85% of conventional patients, and 86% of converted patients. Age, sex, signs and symptoms, complications, and operative times were similar in laparoscopic and conventional groups. Mean hospital stay was 3.5 days in the laparoscopic group, 4.5 days in the conventional group, and 8.5 days in the converted group. Operating room charges were highest in the laparoscopic group. Surgical procedure depended on the experience and bias of the attending surgeon. Laparoscopic appendectomy appears to be easily learned by surgical residents and to be associated with an outcome similar to that of conventional appendectomy.
腹腔镜阑尾切除术对住院医师培训来说是另一项挑战。本回顾性研究旨在确定该手术的疗效，将其与传统阑尾切除术进行对比，并描述在带教住院医师方面的经验。我们查阅了1990年9月至1992年9月期间由住院医师实施阑尾切除术的151例患者的病例记录。26%的病例采用腹腔镜手术，65%采用传统方法，9%的患者中转开腹手术。腹腔镜手术患者中56%确诊为急性阑尾炎，传统手术患者中85%确诊，中转手术患者中86%确诊。腹腔镜组和传统组在年龄、性别、体征和症状、并发症及手术时间方面相似。腹腔镜组平均住院时间为3.5天，传统组为4.5天，中转组为8.5天。腹腔镜组手术室费用最高。手术方式取决于主刀医生的经验和偏好。腹腔镜阑尾切除术似乎很容易被外科住院医师掌握，且其结果与传统阑尾切除术相似。
