Frazee R C, Roberts J W, Symmonds R E, Snyder S K, Hendricks J C, Smith R W, Custer M D, Harrison J B
Department of General Surgery, Scott and White Memorial Hospital, Sherwood, Texas.
Ann Surg. 1994 Jun;219(6):725-8; discussion 728-31. doi: 10.1097/00000658-199406000-00017.
The authors determined whether there was an advantage to laparoscopic appendectomy when compared with open appendectomy. SUMMARY/BACKGROUND DATA: The advantages of laparoscopic appendectomy versus open appendectomy were questioned because the recovery from open appendectomy is brief.
From January 15, 1992 through January 15, 1993, 75 patients older than 9 years were entered into a study randomizing the choice of operation to either the open or the laparoscopic technique. Statistical comparisons were performed using the Wilcoxon test.
Thirty-seven patients were assigned to the open appendectomy group and 38 patients were assigned to the laparoscopic appendectomy group. Two patients were converted intraoperatively from laparoscopic appendectomies to open procedures. Thirty-one patients (81%) in the open group had acute appendicitis, as did 32 patients (84%) in the laparoscopic group. Mean duration of surgery was 65 minutes for open appendectomy and 87 minutes for laparoscopic appendectomy (p < 0.001). There were no statistically significant differences in length of hospitalization, interval until resumption of a regular diet, or morbidity. Duration of both parenteral and oral analgesic use favored laparoscopic appendectomy (2.0 days versus 1.2 days, and 8.0 days versus 5.4 days, p < 0.05). All patients were instructed to return to full activities by 2 weeks postoperatively. This occurred at an average of 25 days for the open appendectomy group versus 14 days for the laparoscopic appendectomy group (p < 0.001).
Patients who underwent laparoscopic appendectomies have a shorter duration of analgesic use and return to full activities sooner postoperatively when compared with patients who underwent open appendectomies. The authors consider laparoscopic appendectomy to be the procedure of choice in patients with acute appendicitis.
作者确定与开腹阑尾切除术相比，腹腔镜阑尾切除术是否具有优势。总结/背景数据：由于开腹阑尾切除术的恢复时间较短，腹腔镜阑尾切除术相对于开腹阑尾切除术的优势受到质疑。
从1992年1月15日至1993年1月15日，75名9岁以上的患者进入一项研究，随机选择手术方式为开腹或腹腔镜技术。使用Wilcoxon检验进行统计比较。
37名患者被分配到开腹阑尾切除术组，38名患者被分配到腹腔镜阑尾切除术组。2名患者在术中从腹腔镜阑尾切除术转为开腹手术。开腹组31名患者（81%）患有急性阑尾炎，腹腔镜组32名患者（84%）患有急性阑尾炎。开腹阑尾切除术的平均手术时间为65分钟，腹腔镜阑尾切除术为87分钟（p< .001）。住院时间、恢复正常饮食的间隔时间或发病率无统计学显著差异。胃肠外和口服镇痛药的使用时间均有利于腹腔镜阑尾切除术（分别为2.0天对1.2天，8.0天对5.4天，p< .05）。所有患者均被指示在术后2周恢复全部活动。开腹阑尾切除术组平均在25天恢复，而腹腔镜阑尾切除术组平均在14天恢复（p< .001）。
与接受开腹阑尾切除术的患者相比，接受腹腔镜阑尾切除术的患者镇痛药使用时间较短，术后恢复全部活动更快。作者认为腹腔镜阑尾切除术是急性阑尾炎患者的首选手术方式。
