阑尾炎再手术15例原因分析

Secondary Laparotomy after Appendectomy (A Report of 15 Cases)

目的分析阑尾炎再手术原因,探讨预防或减少阑尾炎手术后并发症的措施。方法回顾性分析15例阑尾切除术后再手术的临床资料。结果再手术的原因为漏诊结肠癌、阑尾恶性肿瘤5例,阑尾残株炎2例,Meckel憩室、回肠末端结核、阑尾动脉出血、盆腔脓肿、腹腔动脉卒中、盲肠瘘、粘连性肠梗阻、腹壁窦道形成各1例,予相应的再次手术治疗,除1例腹腔动脉卒中患者术后死于短肠综合征外,其余均痊愈出院。结论重视阑尾炎术前及术中的诊断及鉴别诊断,重视术中操作及术后并发症的处理,可减少或避免再手术的机会。

Objective To study the causes of secondary laparotomy after appendectomy and explore the approaches of preventing and treating the complications of appendectomy. Methods 15 cases of secondary laparotomy after appendectomy were retrospectively reviewed. Results Secondary laparotomy were indicated by misdiagnosis of colonic carcinoma and appendical malignant tumor in 5 cases, stump appendicitis in 2 cases, Meckel＇s diverticulum, terminal ileum tuberculosis, appendicular artery hemorrhage, pelvic abscess, celiac arterial apoplexia,cecum fistula, adhensive intestinal obstruction, and abdominal wall fistula in 1 case each. All cases cured except 1 died of short-bowel syndrome secondary to celiac arterial apoplexia. Conclusion Attention should be seriously paid on the preoperative and intraoperative diagnosis of appendicitis, and along with the proper intraoperative and postoperative treatment, can prevent the secondary laparotomy after appendectomy.