单纯腹腔镜阑尾切除术476例临床分析

目的：探讨腹腔镜阑尾切除术（laparoscopic appendectomy，LA）的临床应用价值。方法：回顾分析2004年1月至2010年12月为476例患者施行腹腔镜阑尾切除术的临床资料。结果：473例成功完成LA，3例中转开腹，手术时间15～90min，平均（41．15±10．10）min；术中出血5～50ml，平均（9．2±8．5）ml；术后应用抗生素时间平均（3．1±1．4）d；术后住院2-6d，平均3．5d。随访342例（72．7％），随访时间3—240个月，平均55个月，无一例未发生肠漏、切口感染、残株炎、腹腔脓肿、粘连性肠梗阻、切口疝等手术并发症。结论：LA治疗阑尾炎安全、有效，具有患者创伤小、痛苦轻、术后住院时间短、康复快、荧容效果好、并发症少等特点。

Objectlve：To study the clinical application value of laparoscopic appendectomy （LA）. Methods：The clinical dataoi238 patients performed LA from Jan. 1998 to Dec. 2010 were analyzed retrospectively. Results：The procedure was successfuUy accomplished in 476 cases,while 3 caseswere converted to laparotomy. The operating time was 15 - 80min, mean （41.2 ± 10.10 ） min. Thehloed lostwas 5 - 50ml mean （9.2 ± 8.5 ） ml Themean periods of antibiotic use were （3.1 ±1.4） d. The postoperative hospital stay was 2 - 6d, mean 3.5 d. Follow - up datawere available for 342 patients （72.7 % ） from 3 to 240 months, mean 52 months, no intestinal fistula,infection of incisional wound,residual appendicitis,intraabdominal abscess,adhesive intestinal obstruction,or incisional hemiawere found during follow up time. Conclusions： LA is safe and effective for appendicitis,with advantages such asmoreminimal trauma, less suffering, faster recovery, shorterhespital stay, better cosrnesis and less complications.