免钛夹腹腔镜阑尾切除术临床体会

目的探讨采用普通丝线代替金属钛夹进行腹腔镜阑尾切除术(LA)的可行性、安全性以及临床效果。方法 2008年8月～2009年12月,在外科诊断为急、慢性阑尾炎的106例患者进行腹腔镜阑尾切除手术,术中采用普通丝线代替金属钛夹结扎阑尾动脉及根部,并对临床资料进行回顾性分析总结。结果全组患者均采用三孔法完成腹腔镜阑尾切除,无中转开腹,术后无出血、肠漏、腹腔脓肿及伤口感染等相关并发症发生,手术时间30～90min,平均时间34min,平均住院时间4天,术后随访4～64W,未诉明显不适。结论 LA术中采用普通丝线代替金属钛夹结扎阑尾动脉及根部,取材方便,简单易行,经济实用,避免了金属钛夹的缺点,且对于阑尾根部粗大者更为适用,在临床上是安全的,可行的,值得推广。

Objective To investigate the feasibility,safety and clinical effect of laparoscopic appendectomy（LA） for using the ordinary silk thread instead of titanium clips.Methods According to the clinical data and laparoscopic appendectomy（LA） using common silk thread instead of titanium clamp to ligate appendix artery and root of the 106 patients suffered from acute and chronic appendicitis in our department From August 2008 to December 2009,we try to make a retrospective analysis.Results All cases were successfully done with three-hole method,there was no conversion,no postoperative bleeding,no bowel leakage,no intra-abdominal abscess and no wound infection and other related complications.the operation time had a range between 30 and 90 min,the average time was 34.5min,the average hospitalization was 4 days,postoperative follow-up 4~64W,no obvious discomfort.Conclusion Laparoscopic appendectomy using the common silk thread instead of titanium clamp to ligate appendix artery and root is more convenient in material,simpler,more economical and practical,especially for the bulky Appendix root patients.This method is safe,feasible and it can be taken as the best choice of appendectomy.