Houben F, Willmen H R
Chirurgische Klinik, Kreiskrankenhauses Grevenbroich.
Chirurg. 1998 Jan;69(1):66-70; discussion 70-1. doi: 10.1007/s001040050375.
Since 1975, the Department of Surgery in the Grevenbroich Community Hospital (Germany) has applied a simplified technique of open appendectomy. The inhouse modified procedure without stump embedding has been performed in 3,448 cases to date. The same approach has been used in 1,463 laparoscopic appendectomies since 1991. In the laparoscopic procedure the stump is ligated solely with Roeder's loop. None of the 4,911 patients who have undergone either open or laparoscopic appendectomy have developed stump inadequacy or stercoral fistulae. According to the special literature, the complication rate after appendectomies without stump embedding is lower than that after standard procedures. In retrospect, laparoscopic appendectomy with simple ligation has confirmed the results achieved with simple ligation in open appendectomies. The technique should therefore become more common practice in open appendectomies, as well.
自1975年以来,德国格伦布罗伊希社区医院外科应用了一种简化的开放式阑尾切除术技术。迄今为止,已对3448例患者实施了不埋入残端的院内改良手术。自1991年以来,1463例腹腔镜阑尾切除术采用了相同的方法。在腹腔镜手术中,残端仅用罗德环结扎。接受开放式或腹腔镜阑尾切除术的4911例患者均未出现残端愈合不良或粪瘘。根据专业文献,不埋入残端的阑尾切除术后并发症发生率低于标准手术。回顾过去,单纯结扎的腹腔镜阑尾切除术证实了在开放式阑尾切除术中单纯结扎所取得的效果。因此,该技术在开放式阑尾切除术中也应成为更常见的做法。