摘要
目的:总结复杂性阑尾炎的腹腔镜手术经验,并探讨其安全性与可行性。方法:回顾分析2010年1月至2013年5月为220例复杂性阑尾炎患者行腹腔镜手术的临床资料。结果:214例顺利完成腹腔镜手术,6例中转开腹。手术时间40~240 min,平均(78±26)min;术后排气时间12 h^5 d,平均(48±16)h;住院4~13 d,平均(4.8±2.8)d;术后并发右下腹炎性包块4例、盆腔脓肿2例,经消炎、局部理疗等处理治愈;左下腹切口感染8例,经换药治愈。患者均治愈,无术后大出血、阑尾残端瘘、肠瘘、肠梗阻等严重并发症发生。随访3个月~2年,无肠粘连、肠梗阻、阑尾残株炎等并发症发生。结论:腹腔镜手术治疗复杂性阑尾炎是安全、可行的,手术难点主要在于阑尾的显露、系膜与根部的处理及腹腔脓液的清除。
Objective ：To summarize the experience of laparoscopic surgery for complicated appendicitis, and to discuss its safe- ty and feasibility. Methods：A retrospective analysis was made on the clinical data of 220 patients who suffered from complicated appen- dicitis and underwent laparoscopic operation from Jan. 2010 to May 2013. Results：Among the 220 cases,214 cases underwent laparos- copy, another 6 cases were converted to laparotomy. The time of operation was 40 min to 4 h, mean （78 ＋ 26） min; The exhaust time af- ter operation was 12 h to 5 d,mean （48 ＋ 16） h;The hospital stay lasted 4-13 d,mean （4.8 ＋2.8） d;Mter surgery 4 patients suffered from inflammatory mass in right lower quadrant abdomen and 2 patients from pelvic abscess, who were all cured by anti-inflammation and local physical therapy;8 cases experienced incision infection at left lower quadrant of the abdomen, who were cured by surgical dressing change. All patients were cured without complications of postoperative hemorrhage, appendix stump fistula, intestinal fistula, in- testinal obstruction and so on. During the follow-up visit lasted 3 months to 2 years, there were no complications such as intestinal adhe- sion,intestinal obstruction or appendix stump inflammation. Conclusions： Laparoscopic surgery is safe and feasible in the treatment of complicated appendicitis, it would be a conventional operation in the future. The operative difficulties include the exposure of the appen- dix, disposal of the mesoappendix and appendix root, and cleaning of the pyoceliao
出处
《腹腔镜外科杂志》
2014年第2期141-143,共3页
Journal of Laparoscopic Surgery
