腹腔镜阑尾切除术493例临床分析

The clinical analysis of 493 cases of laparoscopic appendectomy

目的：总结腹腔镜阑尾切除术（laparoscopic appendectomy,LA）的临床应用体会。方法：回顾分析2004年1月至2009年3月我院行LA治疗493例阑尾炎患者的临床资料,其中单纯性阑尾炎22例,化脓性阑尾炎316例,坏疽穿孔性阑尾炎134例,慢性阑尾炎21例。结果：493例LA均获成功,无一例中转开腹,手术时间12~61min,平均36.5min,术中出血2~10ml。术后6例发生并发症,4例戳孔感染,经换药后痊愈,2例术后阑尾残端漏,保守治疗5~7d后治愈。住院3~7d,平均4d。结论：LA具有患者创伤小,康复快,并发症少,术后切口平整、美观等优点。

Objective：To summarize the clinical experience of laparoscopic appendectomy（LA）.Methods：A retrospective analysis was made on the clinical data of 493 patients with appendicitis who underwent LA in our hospital from Jan.2004 to Mar.2009.There were 22 cases of simple appendicitis,316 cases of suppurative appendicitis,134 cases of gangrenous and perforating appendicitis,and 21 cases of chronic appendicitis.Results：All of the 493 cases succeeded in LA,without conversion to open approach.The mean operative time was 36.5min（range 12-61）,blood loss was 2-10ml during operation.Postoperative complications occurred in 6 cases：4 cases of wound infection were cured by dressing change,2 cases of postoperative appendix remnant fistula recovered after 5-7 days by conservative treatment.Hospital stay was 3-7d,average 4d.Conclusions：LA has the advantages of less trauma,faster recovery,fewer complications,better cosmetic result and so on.