经剖宫产术后腹壁瘢痕做切口行腹腔镜手术治疗急性阑尾炎

Laparoscopy for acute appendicitis via scar on abdominal wall after cesarean section

目的:总结经剖宫产术后腹壁瘢痕做切口行腹腔镜手术治疗急性阑尾炎的临床经验。方法:回顾分析2005年12月至2008年7月我院实施的经剖宫产术后腹壁瘢痕做切口行腹腔镜手术治疗急性阑尾炎36例患者的临床资料。结果:36例均顺利完成腹腔镜手术,无中转开腹。2例术中探查证实为黄体破裂,行电凝止血术;1例右侧输卵管积脓伴盆腔炎,行患侧输卵管切除加盆腔冲洗。无术后出血、感染等并发症发生。结论:经剖宫产术后腹壁瘢痕做切口行腹腔镜手术治疗急性阑尾炎安全可行,不增加明显手术瘢痕,具有美容效果。对育龄妇女的右下腹痛,阑尾炎诊断可疑者,腹腔镜可以明确诊断并确切治疗。

Objective：To summarize the experience of laparoscopy for acute appendicitis via scar on abdominal wall after cesarean section. Methods ： Clinical data of 36 cases with acute appendicitis underwent laparoscopy via scar on abdominal wall after cesarean section from Dee. 2005 to Jul. 2008 were analyzed retrospectively. Results ： All operations were successful, without conversion to open surgery. 2 cases were diagnosed as rupture of corpus luteum and were treated with electrocoagulation. 1 case was diagnosed as fight pyosalpinx combined with acute pelvic inflammation, and was treated with affected tubal resection and irrigation of abdominal cavity. There were no complications such as postoperative bleeding and infection. Conclusions：With improved cosmetic result and without additional visible scar, laparoscopy for acute appendicitis via scar on abdominal wall after cesarean section is safe arid feasible. Laparoseopy can give definite diagnosis and precise treatment for acute unexplained pain in right lower quadrant for reproductive women.