Koch A, Lippert H
Chirurgische Klinik Carl-Thiem-Klinikum, Cottbus.
Zentralbl Chir. 1998;123 Suppl 4:43-5.
The diagnostic laparoscopy represents a special technique with high impact for differential diagnosis especially in patients with chronic recurrent pain in the right lower abdomen. The East-German multicentric trial confirmed the actual trend of increasing importance of the laparoscopic method especially in patients with unclear abdominal findings. In case of surgical treatment because of chronic appendicitis in 61.7% (n = 370) of all these cases an laparoscopic procedure was preferred. Unclear abdominal findings were treated in 73.7% (n = 205) laparoscopically. In case of acute appendicitis in 72.2% (n = 2934) the open procedure was preferred. The diagnostic laparoscopy can avoid the overlook of findings requiring therapy. The consequent laparoscopic approach allows to achieve a decreased rate of non necessary laparotomies as well as non detected findings requiring surgery. The rate of gynaecological findings was 16.2% (n = 184) of all women who underwent diagnostic laparoscopy versus 6.4% who underwent open appendectomy (n = 116).
诊断性腹腔镜检查是一种特殊技术,对鉴别诊断有很大影响,尤其是对右下腹部慢性复发性疼痛的患者。东德多中心试验证实了腹腔镜检查方法重要性日益增加的实际趋势,特别是对于腹部检查结果不明确的患者。在所有因慢性阑尾炎接受手术治疗的病例中,61.7%(n = 370)首选腹腔镜手术。73.7%(n = 205)腹部检查结果不明确的患者接受了腹腔镜治疗。在急性阑尾炎病例中,72.2%(n = 2934)首选开放手术。诊断性腹腔镜检查可避免遗漏需要治疗的病变。采用一贯的腹腔镜检查方法可以降低不必要的剖腹手术率以及未发现的需要手术治疗的病变率。接受诊断性腹腔镜检查的所有女性中,妇科病变率为16.2%(n = 184),而接受开放性阑尾切除术的女性中这一比例为6.4%(n = 116)。