Barkhausen S, Wullstein C, Gross E
1. Chirurgische Abteilung, Allgemeines Krankenhaus Barmbek, Hamburg.
Zentralbl Chir. 1998;123(7):858-62.
To compare the complications of laparoscopic appendectomy (LA) and conventional appendectomy (CA) 930 consecutive patients from 1989 until 1997 were analysed retrospectively.
Conventional appendectomy was performed in 330 patients, laparoscopic in 554 patients and another 46 patients required conversion after laparoscopy. The groups were similar in sex ratio, age and degree of inflammation. Postoperative complications occurred in 8.78%. There were less complications in the LA-group (4.69%) than in the CA-group (13.33%) (p < 0.01), especially wound infections were found less in the LA-group (1.8% vs. 11.21%, p < 0.01). The incidence of intraabdominal abscesses was similar in the LA and CA group (1.44% vs. 1.52%). The differences between the groups are not influenced by complicating appendicitis (perforation or abscess). Systemic complications were similar for LA and CA (0.72% and 0.61%), but were seen more often after conversion (6.52%, p < 0.01).
This retrospective analysis shows that laparoscopic appendectomy significantly reduces postoperative complications, especially wound infections. The authors consider laparoscopic appendectomy to be the procedure of choice in patients with acute appendicitis.
为比较腹腔镜阑尾切除术（LA）与传统阑尾切除术（CA）的并发症，对1989年至1997年间连续的930例患者进行回顾性分析。
330例患者接受传统阑尾切除术，554例患者接受腹腔镜手术，另有46例患者在腹腔镜检查后需要中转开腹。两组在性别比例、年龄和炎症程度方面相似。术后并发症发生率为8.78%。LA组（4.69%）的并发症少于CA组（13.33%）（p<0.01），尤其是LA组的伤口感染较少（1.8%对11.21%，p<0.01）。LA组和CA组腹腔内脓肿的发生率相似（1.44%对1.52%）。两组之间的差异不受复杂性阑尾炎（穿孔或脓肿）的影响。LA组和CA组的全身并发症相似（0.72%和0.61%），但在中转开腹后更常见（6.52%，p<0.01）。
这项回顾性分析表明，腹腔镜阑尾切除术显著降低了术后并发症，尤其是伤口感染。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。
