摘要
目的探讨经脐单一部位腹腔镜阑尾切除术(transumbilical single-incision laparoscopic appendectomy,TUSILA)的安全性和可行性。方法 2011年1～10月我院行28例TUSILA。在脐下缘做一15～20 mm弧形切口,置入2个10 mmtrocar和1个5 mm trocar,置入10 mm 30°电子腹腔镜和腹腔镜器械,完成阑尾切除术。结果 26例成功施行TUSILA,1例盲肠后位阑尾炎中转开腹,1例改三孔法腹腔镜阑尾切除术。26例TUSILA手术时间25～60 min,(40.6±12.8)min;术后24h下床活动,恢复流质饮食;术后2～5 d出院。26例随访1～6个月,平均4.6月,均无术后出血、肠漏、切口感染等并发症,切口瘢痕隐蔽,患者对美容效果满意。结论 TUSILA安全可行,美容效果突出,与传统腹腔镜阑尾切除术相比,操作难度增加,术者须严格掌握手术适应证,操作困难时应及时转为常规腹腔镜或中转开腹手术。
Objective To evaluate the safety and feasibility of transumbilical single-lncision laparoscopic appendectomy （TUSILA）. Methods The clinical data of 28 patients, who underwent TUSILA in our hospital from January 2011 to October 2011, was retrospectively analyzed. We made a 15- to 20-mm curve incision at the inferior border of the umbilicus, via which, we placed two 10-mm and one 5-mm trocars, so that to insert laparoscope （10 mm, 30~） and other surgical equipments to complete appendectomy. Results The procedure was completed in 26 of the 28 patients, the other two were converted to three-port laparoscopy or open surgery （because of retrocecal appendicitis）. In the 26 cases, the mean operation time was （40.6 ＋ 12.8） min （ranged from 25 to 60 min） ; all of them recovered out-of-bed activity and liquid diet in 24 hours. They were discharged from hospital in 2 to 5 days postoperation. The 26 patients were followed up for 1 to 6 months with a mean of 4.6 months, during which no postoperative hemorrhage, intestinal leakage,or incisional infection occurred, and the patients were satisfied with cosmetic results of the procedure. Conclusions TUSILA is safe and feasible with good cosmetic outcomes. Compared to traditional laparoscopic appendectomy, it is however more difficult, therefore we suggest strict surgical indications and conversion to open surgery or conventional laparoscopy when necessary.
出处
《中国微创外科杂志》
CSCD
2012年第10期919-921,共3页
Chinese Journal of Minimally Invasive Surgery
