Schreiber J H
Tagesklinik, Mettmann, Germany.
Endoscopy. 1994 Mar;26(3):292-8. doi: 10.1055/s-2007-1008970.
The results of laparoscopic appendectomy under outpatient conditions are reported here from a retrospective analysis of the data for 78 women (aged 17-55) selected as having clinically acute or subacute appendicitis. Patients with severe disease presenting with sepsis or peritonitis were excluded, since they were referred to hospital. The duration of the procedure in the 78 women was 30-120 minutes (mean: 45), and only one minor intraoperative complication (a slight lesion to the uterus from the working trocar) was encountered. Follow-up was carried out by daily telephone interviews and a physical examination on the third or fourth postoperative day. Five postoperative complications (four cases of peritonitis and one stump insufficiency) were found two to seven days after the laparoscopic appendectomy, and these had to be treated by laparotomy. No severe sequelae or mortality were encountered. The calculated costs of the laparoscopic approach (DM 1,000.00 in total for anesthesia and operation) compared favorably with a conventional inpatient regimen covering seven days (DM 3,000.00-5000.00). We conclude that laparoscopic appendectomy under outpatient conditions is a safe and cost-effective modality for treating acute and subacute appendicitis in selected patients.
本文通过对78例（年龄17 - 55岁）临床诊断为急性或亚急性阑尾炎的女性患者数据进行回顾性分析，报告了门诊条件下腹腔镜阑尾切除术的结果。患有严重疾病并伴有败血症或腹膜炎的患者被排除，因为他们被转诊至医院。78例女性患者的手术时长为30 - 120分钟（平均45分钟），术中仅出现1例轻微并发症（工作套管针导致子宫轻微损伤）。通过每日电话随访以及术后第三天或第四天的体格检查进行随访。在腹腔镜阑尾切除术后两至七天发现5例术后并发症（4例腹膜炎和1例残端漏），这些并发症均需通过开腹手术治疗。未出现严重后遗症或死亡病例。腹腔镜手术方式的计算成本（麻醉和手术总计1000.00德国马克）与传统住院七天治疗方案（3000.00 - 5000.00德国马克）相比更具优势。我们得出结论，门诊条件下的腹腔镜阑尾切除术对于特定患者治疗急性和亚急性阑尾炎是一种安全且具有成本效益的方式。
