摘要
目的:对比分析单孔法与三孔法腹腔镜阑尾切除术(laparoscopic appendectomy,LA)的安全性。方法:2009年7月至2014年7月收治51例阑尾炎患者,术前均签署知情同意书,根据随机原则分为两组,观察组行单孔LA(n=25),对照组行三孔法LA(n=26),对比两组患者手术时间、出血量、术后住院时间、并发症发生率等。结果:观察组1例患者因阑尾根部坏疽穿孔转为三孔法,1例患者术后出现腹腔残余感染。对照组2例中转开腹,1例患者因房颤导致中风,与其基础疾病有关。均无围手术期死亡及严重并发症发生。单孔组手术时间较三孔组长。两组患者手术出血量、术后住院时间、并发症发生率等差异无统计学意义。结论:单孔法LA疼痛轻,美容满意度高,安全、可靠。术前应严格把握手术指征、选择合适的手术方案,以减少手术并发症及中转开腹。
Objective：To comparatively analyze the security of the single-port and three-port laparoscopic appendectomy（LA）for the treatment of appendicitis. Methods：During Jul. 2009 and Jul. 2014,51 patients who suffered from appendicitis were randomly divided into single-port and three-port groups. All the patients signed the informed consent before treatment,and expressed informed consent about research. 25 cases in the observation group were performed the single-port LA;26 cases in the control group were performed the three-port LA. The operative time,blood loss,postoperative hospital stay,incidence of operative complications were compared between the two groups. Results：In the single-port group,1 case of root gangrenous perforative appendicitis was converted to three-port surgery. 1 case was found abdominal residual infection. In the three-port group,2 cases were converted to open appendectomy,because of atrial fibrillation 1 patient had a stroke,which was closely related to underlying diseases and was not related to operation. No perioperative deaths or serious complications occurred. The single-port group showed significantly longer operative time than the three-port LA.In the 2 groups,the operative blood loss,postoperative hospital stay,and incidence of operative complications were not significantly different（ P 0. 05）. Conclusions：The single-port LA is safe and reliable with little pain and high satisfaction with the cosmetic outcomes. Surgeons should strictly control indications before operation,choose appropriate operative program,in order to decrease operative complications and conversion to laparotomy.
出处
《腹腔镜外科杂志》
2015年第2期140-143,共4页
Journal of Laparoscopic Surgery
基金
浙江省医药卫生科技计划(编号:2014ZDA028)
