摘要
目的对比分析腹腔镜阑尾切除术（1aparoscopic appendectomy，LA）和开腹阑尾切除术（open appendectomy，OA）治疗伴有坏疽、穿孔及阑尾周围脓肿的儿童阑尾炎的疗效。方法回顾性分析614例儿童复杂性阑尾炎患者的临床资料，比较LA组（267例）和OA组（347例）手术时间、住院时间、住院费用及术后并发症的发生率。结果本组614例患者中无手术死亡发生，LA组有7例中转开腹手术，LA组术后住院时间较OA组短（4．6d比8．1d，P=0．00），Trocar孔或切口感染（5．3％比12．8％，P=0．03）、肠梗阻（5．0％比10．0％，P：0．04）及院内感染发生率（9．7％比18．3％，P=0．04）均较OA组低。术后LA组腹腔脓肿发生率较OA组高（4．1％比1．1％，P=0．04），差异有统计学意义。两组的手术时间及费用之间比较差异无统计学意义（均P〉0．05）。结论LA具有创伤小、恢复快、并发症少、住院时间短等优点，是治疗儿童复杂性阑尾炎一种安全有效的手术方式，但术后腹腔脓肿发生率偏高。
Objective- To compare laparoscopic appendectomy （LA） with open appendectomy （OA） in the treatment of appendicitis complicating gangrene, perforation and abscess in children. Methods This study included 614 consecutively admitted patients with acute complicated appendicitis undergoing laparoscopic （267 cases） or open （347 cases） appendectomy. Clinical outcomes were compared between the 2 groups in relation to operative time, length of hospital stay, postoperative complications and in hospital cost. Results There was no mortality. Conversion to open surgery was necessary in 7 patients in LA group. Laparoscopic appendectomy was associated with a shorter hospital stay （4. 6 d vs. 8. 1 d, P = 0. 00）, lower incidence of wound infection（5.3% vs. 12. 8% , P =0. 03） , less bowel obstruction（5.0% vs. 10. 0% , P =0. 04） and nosocomial infection （9. 7% vs. 18. 3% , P =0.04）. Intra-abdominal abscess formation was significantly higher after laparoscopic surgery （4. 1% vs. 1.1%, P = 0. 04 ）. The cost of treatment and operative time were higher in the laparoseopie group than in open appendectomy, however, there was no statistically significant difference. Condusions Laparoscopic technique is a safe and clinically beneficial operative procedure for complicated appendicitis in children with short hospital stay, early recovery, good cosmetic appearance, and low complication rate, except for a higher incidence of intra- abdominal abscess.
出处
《中华普通外科杂志》
CSCD
北大核心
2012年第3期207-209,共3页
Chinese Journal of General Surgery
关键词
阑尾炎
腹腔镜
阑尾切除术
Appendicitis
Laparoscopes
Appendectomy
