摘要
目的基于超级微创理念探讨内镜下治疗急性阑尾炎(AA)的初步疗效。方法选取南京中医药大学附属江苏省中医院消化内镜中心2022年9月至2023年5月因AA住院接受内镜下治疗的7例患者,回顾性分析治疗方法、成功率、手术时间、住院时间、并发症、症状缓解及复发情况等。结果7例AA患者中,6例为非复杂性阑尾炎,其中,1例为阑尾粪石嵌顿行内镜下阑尾肌切开取石术、1例阑尾脓肿行内镜下阑尾直接切开排脓、4例行内镜逆行性阑尾炎治疗(ERAT,包括冲洗、支架置入、网篮取石;其中,1例应用直视镜辅助内镜下逆行阑尾炎探查及灌洗术)、1例为复杂性阑尾炎伴周围脓肿包裹形成,行ERAT及支架引流。手术平均时间30.43 min,患者自觉腹痛消失平均时间为术后1 d,内镜治疗均成功。患者平均开放饮食时间为2 d,平均住院时间6.14 d。患者随访4~12个月,阑尾周围脓肿患者行择期外科阑尾切除术,其余无并发症发生。结论基于超级微创理念内镜下微创治疗AA安全有效、方式多样,仍需进一步的对照研究。
Objective To explore the preliminary effect of endoscopic treatment of acute appendicitis based on the concept of super-minimally invasive technique.Methods The study was performed on 7 patients who underwent endoscopic therapy for acute appendicitis at Jiangsu Province Hospital of Chinese Medicine from September 2022 to May 2023.The methods of treatment,success rate,operation duration,hospital stay,complications,symptom remission and recurrence were analyzed retrospectively.Results A total of 7 patients with acute appendicitis were collected,including 6 acute uncomplicated appendicitis:One case of impacted appendiceal fecalith incarceration underwent endoscopic appendiceal orifice myotomy and lithotomy;One case of appendix abscess was treated by drainage of pus and decompression with endoscopic appendiceal orifice myotomy;4 patients with acute appendicitis underwent endoscopic retrograde appendicitis therapy(ERAT,including irrigation、stent placement、basket lithotomy),in one case,endoscopic retrograde appendiceal exploration and lavage were operated with the auxiliary eyeMax.One case of complicated appendicitis with peripheral abscess was treated with ERAT and stent drainage.The average procedure time was 30.43 min.Averagely,abdominal pain was relieved one day after the procedure,and all endoscopic treatments in these patients were successful.The average allowable feeding time after surgery was 2 days.The average post-operative hospital stay was 6.14 days.No recurrence occurred during 4 to 12 months′follow-up,except the case with peripheral abscess undergoing elective surgical appendectomy.Conclusion Based on the super-minimally invasive concept,endoscopic minimally invasive treatment of acute appendicitis is safe and effective in various ways,but further controlled studies are needed.
作者
毛丽娟
张婷
孙仁虎
吴大鹏
金海林
卢晓云
李文杰
凌亭生
张其德
Lijuan Mao;Ting Zhang;Renhu Sun;Dapeng Wu;Hailin Jin;Xiaoyun Lu;Wenjie Li;Tingsheng Ling;Qide Zhang(Digestive Endoscopy Center,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)
出处
《中华胃肠内镜电子杂志》
2024年第1期7-12,共6页
Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition)
基金
2023年江苏省中医院院级新技术项目(20230001)
关键词
阑尾炎
超级微创理念
阑尾肌切开术
内镜逆行阑尾炎治疗术
Appendicitis
Super-minimally invasive concept
Endoscopic appendiceal orifice myotomy
Endoscopic retrograde appendicitis therapy
