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间隔期阑尾切除术:一项回顾性研究。

Interval appendicectomy: a retrospective study.

作者信息

Eriksson S, Styrud J

机构信息

Department of Surgery, Karolinska Institutet at Danderyd Hospital, Sweden.

出版信息

Eur J Surg. 1998 Oct;164(10):771-4; discussion 775. doi: 10.1080/110241598750005417.

Abstract

OBJECTIVE

To investigate the complication rate after open interval appendicectomy and compare it with the complication rate after acute appendicectomy.

DESIGN

Retrospective study.

SETTING

Teaching hospital, Sweden.

SUBJECTS

38 patients with appendiceal abscess or chronic appendicitis who underwent interval appendicectomy.

MAIN OUTCOME MEASURES

Operative and histological findings, and postoperative complications after interval appendicectomy.

RESULTS

The reasons for interval appendicectomy were appendiceal abscess (n = 32, verified by ultrasonography in 25 cases), chronic appendicitis (n = 4), and previous acute appendicitis (n = 2). Five patients underwent drainage of the abscess during the acute episode. The median interval between first symptoms of appendicitis and interval appendicectomy was 3.5 months (range 1.5-15). In two patients (5%) there were no macroscopic or microscopic signs of previous appendicitis and in one patient (61 years old) an adenocarcinoma was found in the base of the appendix. The complication rate was 13% (5/38), which is similar to our morbidity after acute appendicectomy (244/2352, 10%).

CONCLUSIONS

Interval appendicectomy has the same complication rate as acute appendicectomy, and is hardly ever done. We no longer recommend it as a routine and it should be done only for special indications such as persisting complaints that suggest appendicitis.

摘要

目的

调查开放性间隔期阑尾切除术后的并发症发生率,并与急性阑尾炎切除术后的并发症发生率进行比较。

设计

回顾性研究。

地点

瑞典的教学医院。

研究对象

38例行间隔期阑尾切除术的阑尾脓肿或慢性阑尾炎患者。

主要观察指标

间隔期阑尾切除术的手术及组织学检查结果以及术后并发症。

结果

间隔期阑尾切除术的原因包括阑尾脓肿(n = 32,25例经超声证实)、慢性阑尾炎(n = 4)和既往急性阑尾炎(n = 2)。5例患者在急性发作期进行了脓肿引流。阑尾炎首发症状至间隔期阑尾切除术的中位间隔时间为3.5个月(范围1.5 - 15个月)。2例患者(5%)无既往阑尾炎的宏观或微观体征,1例患者(61岁)在阑尾根部发现腺癌。并发症发生率为13%(5/38),与我们急性阑尾炎切除术后的发病率(244/2352,10%)相似。

结论

间隔期阑尾切除术与急性阑尾炎切除术的并发症发生率相同,且很少进行。我们不再推荐将其作为常规手术,仅在存在提示阑尾炎的持续症状等特殊指征时进行。

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