腹腔镜下阑尾切除术40例报告

Laparoscopic appendectomy: A report of 40 cases

目的探讨对急性阑尾炎患者实施腹腔镜下阑尾切除术的优势。方法回顾性分析我院2009年5月-2011年2月40例急性阑尾炎患者行腹腔镜下阑尾切除术,并同期处理腹腔内伴随其他疾病。结果 40例均于腹腔镜下顺利完成阑尾切除术,其中肥胖患者26例(BMI≥30),14例伴有不同程度其他疾病,手术时间20-65min,平均30min,无中转开腹,无术后出血、肠漏、残株炎、trocar口感染、肠梗阻等并发症发生。术后2-5d痊愈出院。术后病理报告:急性单纯性阑尾炎10例,急性化脓性阑尾炎22例,急性坏疽性阑尾炎8例。38例术后随访6-24个月,平均12个月,均未发生与腹腔镜和手术本身相关并发症。结论腹腔镜下阑尾切除术具有手术创伤小、康复快、切口感染率低,对肥胖患者优势更明显,将逐步取代传统手术。

Objective To study the advantages of laparoscopic appendectomy in patients with acute appendicitis.Methods Forty patients with acute appendicitis who underwent laparoscopic appendectomy with their other celiac diseases treated in our hospital from May 2009 to February 2011 were retrospectively analyzed.Results The laparoscopic appendectomy was successful in the 40 patients including 26 obesity patients with their BMI ≥30.Of the 26 obesity patients,14 were complicated with other diseases.The operation time was 20-65min（mean 30min）.No patient was transferred to laparotomy.No complications,such postoperative bleeding,intestinal leakage,stubble inflammation,trocar mouth infection,and intestinal obstruction,occurred after operation.The patients were discharged 2-5 days after operation.Of the 40 patients,10 were diagnosed as simple appendicitis,22 as acute suppurative appendicitis,and 8 as acute gangrenous appendicitis,according to their pathological findings.Thirty-eight patients were followed up for 6-24 months（mean 12 months）,during which no laparoscopic appendectomy-related complications occurred.Conclusion Laparoscopic appendectomy is significantly advantageous for obesity patients due to its minimally invasive trauma,faster recovery,low incision infection rate,and therefore will gradually replace the traditional surgical procedure.