摘要
目的:探讨经脐缘两孔法腹腔镜阑尾切除术的临床疗效。方法:回顾分析2017年7月至2020年6月为166例患者采用经脐缘两孔单器械打结法行腹腔镜阑尾切除术的临床资料。分别于脐缘上、下穿刺10 mm、5 mm Trocar,双极电凝阶梯式电凝阑尾系膜并离断,系膜无需结扎。经腹壁一次性注射器9号针头将7号丝线带入腹腔,线尾留于体外,腹腔镜下单器械打结结扎阑尾根部,切除阑尾。分析手术时间、中转开腹、术后并发症等指标,以明确手术安全性与可行性。结果:164例患者经两孔法顺利完成手术,手术成功率98.80%。2例因回盲部粘连严重,无法游离暴露阑尾,其中1例增加一枚Trocar完成手术,另1例中转开腹。手术时间22~95 min,平均(51.02±12.74)min;术后无相关并发症发生,患者均治愈出院。住院3~8 d,平均(6.34±1.03)d。结论:在熟练掌握腹腔镜下单器械打结技术的条件下,经脐缘两孔法行腹腔镜阑尾切除术操作方便,成功率较高,创伤较小,临床可推广应用。
Objective:To investigate the clinical efficacy of two-port laparoscopic appendectomy through the umbilical border.Methods:From Jul.2017 to Jun.2020,166 cases of two-port laparoscopic appendectomy with single-instrument knotting technique through the umbilical margin were performed,and the clinical data of these patients were retrospectively analyzed.10 mm and 5 mm Trocars were placed on the upper and lower sides of the umbilical border,respectively.Bipolar electrocoagulation was stepwise performed to coagulate the mesoappendix and cut it off,the mesentery did not need to be ligated.The 9F needle of a disposable syringe punctured through the abdominal wall and a 7F silk thread was introduced into the abdominal cavity,the end of the thread was left out of the body.The root of the appendix was ligated with a single instrument under laparoscope,and the appendix was excised.By analyzing the operation time,conversion to laparotomy,postoperative complications and other indicators,the safety and feasibility of the operation were clarified.Results:Among the 166 patients,164 patients successfully completed the operation by the two-port method,and the completion rate was 98.80%.In the other 2 cases,the appendix could not be exposed due to the serious adhesion of the ileocecal region.One of them was added a Trocar to complete the operation,and the other was converted to laparotomy.The operation time was 22-95 min,with an average of(51.02±12.74)min;there were no postoperative complications,and they were all cured and discharged from the h ospital;the hospitalization time was 3-8 d,with an average of(6.34±1.03)d.Conclusions:If the operator is proficient in the laparoscopic single-instrument knotting technique,the two-port laparoscopic appendectomy will be an easy operation with high success rate and mini-invasion,it can be popularized in clinical work.
作者
祁海燕
刘晓光
QI Hai-yan;LIU Xiao-guang(Department of General Surgery,Huaibei Maternity and Child Health Hospital,Huaibei 235000,China)
出处
《腹腔镜外科杂志》
2022年第11期854-857,共4页
Journal of Laparoscopic Surgery
关键词
阑尾切除术
腹腔镜检查
经脐
两孔法
单器械打结技术
Appendectomy
Laparoscopy
Transumbilical
Two-port
Single-instrument knotting technique
