阑尾切除术的改进

The Improvement of the Appendectomy

采用改进的手术方法做了664例阑尾切除术,术后均未出现切口感染、炎性窦道和粘连性肠梗阻,切口近期愈合率为100％。随访表明远期效果亦很理想。新术式的主要特征为不缝合腹膜,腹壁一层缝合,不留永久性缝合线。手术操作要点为:垫高右髂部约45度,切口外移至麦氏切口外侧1～2cm处;阑尾结扎两道,不做荷包包埋;蘸吸清除阑尾周围脓性渗出物,不清洗腹腔;把腹壁作一整层缝合,不缝腹膜;拆线后切口内即无任何异物刺激,不置引流。观察结果与传统术式进行了比较。

With the improved appendectomy, 664 cases were operated on and it was not found in any cases that the incision inflammation , the inflammatory fistula and the intestinal obstruction caused by adhesion occured after the operation. All the incisions healed within 8 days and the percentage of the incisional hernia only was 0. 03. The inquiries were made after the discharging from the hospital and the result was satisfied. This method has threecharac-teristics. I. The incision on the peritoneum is not sutured. 2. The abdominal wall is sutured as one layer. 3. There is on any suture left in the tissue once they were taken from the skin. The main procedure of the operation includes the following. The right iliac region is elevated by cushion for about 45 degree with the surface of the operating table. The incision is made 2cm lateral to the classical one. The base of the appendix is tied up doubly without persestring suture. The puriform excudation is sucked out or cleaned with gauze but the wash of the peritoneal cavity is absolutely not permitted. The abdominal wall is sutured as one unit and the drainage is not needed. The result was compared with that the classical method shown.