特殊类型阑尾炎患者的腹腔镜阑尾切除术

Laparoscopic appendectomy for special cases

目的 探讨扩大腹腔镜外科手术的适应证范围。方法 患急性阑尾炎的孕妇３ 例（妊娠２．５～６．５ 个月），老年患者１２例（６０～７０ 岁），年幼患者５ 例（１１～１５ 岁），胆囊旁阑尾２ 例，盆腔位阑尾４ 例，蛔虫性阑尾炎１ 例，作了腹腔镜阑尾切除术。结果 ２５ 例均成功完成手术，手术时间平均３０．５分钟。１ 例患者术中漏诊直肠上段癌，术后６ 天确诊。并发戳口感染１ 例。结论 腹腔镜阑尾切除术具有创伤小、恢复快及瘢痕小等优点，对孕妇、老年人、小儿、异位阑尾及蛔虫性等特殊类型的阑尾炎，也能体现其优点，值得进一步探索。

Objective Extention in scope of indications for laparoscopy was explored.Methods Laparoscopic appendectomies were performed smoothly in women with pregnancy of 2.5～6.5 months, n=3; in the aged of 60～70 years, n=12; in the young of 11～15 years of age, n=5 and in dislocated appendices as to right upper quadrant, n=2; or into pelvis , n=4, as well as caused by ascaris,n=1. Results The procedure was carried out without difficulty in an average of 30.5 minutes.A missed perforation from rectal cancer was confirmed on the 6 postoperative day. A stab wound infection was recorded. Conclusion The characteristics of laparoscopic appendectomy could be manifested more evidently in special cases as related above.