Kum C K, Ngoi S S, Goh P M, Tekant Y, Isaac J R
Department of Surgery, National University Hospital, Singapore.
Br J Surg. 1993 Dec;80(12):1599-600. doi: 10.1002/bjs.1800801236.
A study was carried out of 137 patients with a diagnosis of acute appendicitis who were randomized to either laparoscopic or open appendicectomy. Patients found to have perforated or normal appendices at histological examination were excluded. Fifty-two patients undergoing laparoscopic appendicectomy and those receiving 57 open procedures were analysed. Laparoscopic appendicectomy took no longer than the open procedure (mean 43 versus 40 min). The number of doses of pethidine (1 mg per kg body-weight) required in the immediate postoperative period did not differ between the two groups but the mean number of doses of oral analgesic (naproxen sodium 550 mg twice daily) required was less in patients undergoing laparoscopic appendicectomy (2.8 versus 5.0, P < 0.05). There was no significant difference between time to resumption of fluid and diet intake and length of hospital stay. There were five (9 per cent) wound infections after open appendicectomy compared with none after the laparoscopic operation (P < 0.01). Patients who underwent laparoscopy returned to full home (17 versus 30 days, P < 0.01) and social (19 versus 32 days, P < 0.05) activities earlier than those who underwent open operation. Laparoscopic appendicectomy may allow reduction in the number of wound infections and earlier return to normal activities.
对137例诊断为急性阑尾炎的患者进行了一项研究，这些患者被随机分为接受腹腔镜阑尾切除术或开腹阑尾切除术。组织学检查发现阑尾穿孔或正常的患者被排除。对52例行腹腔镜阑尾切除术的患者和57例行开腹手术的患者进行了分析。腹腔镜阑尾切除术所用时间不超过开腹手术（平均43分钟对40分钟）。术后即刻所需哌替啶（每千克体重1毫克）的剂量在两组之间无差异，但腹腔镜阑尾切除术患者所需口服镇痛药（萘普生钠550毫克，每日两次）的平均剂量较少（2.8对5.0，P<0.05）。恢复液体和饮食摄入时间及住院时间无显著差异。开腹阑尾切除术后有5例（9%）伤口感染，而腹腔镜手术后无伤口感染（P<0.01）。接受腹腔镜检查的患者比接受开腹手术的患者更早恢复完全的家庭活动（17天对30天，P<0.01）和社交活动（19天对32天，P<0.05）。腹腔镜阑尾切除术可能会减少伤口感染数量并更早恢复正常活动。
