经脐单孔与三孔腹腔镜阑尾切除术的对比研究

Comparative study of transumbilical single-port and three-port laparoscopic appendectomy

目的评价经脐单孔腹腔镜阑尾切除术的安全性和可行性。方法回顾性分析72例患者行腹腔镜阑尾切除术(laparoscopic appendectomy,LA)的临床资料,35例行经脐单孔腹腔镜阑尾切除术(single-port appendectomy,SA),37例行三孔法腹腔镜阑尾切除术(three-port appendectomy,TA)。评价指标包括:手术时间、手术并发症、镇痛药使用次数、住院时间。结果两组的手术时间(P=0.103>0.05)、手术并发症(P=0.227>0.05)、镇痛药使用次数(P=0.717>0.05)、住院时间(P=0.545>0.05)差异均无统计学意义;BMI指数与SA手术时间相关(r=0.17,P=0.016<0.05),穿孔阑尾炎需要更长的手术时间(P=0.005<0.05)。结论经脐单孔SA可取得与TA相同的临床结果,此术式是安全可行的。

Objective To evaluate the safety and feasibility of transumbilical single-port laparoscopic appendectomy （LA）. Methods The clinical data of 72 patients who underwent LA were retrospectively analyzed, of which 35 underwent laparo- scopic transumbilical single-port appendectomy and 37 underwent laparoscopic three-port appendectomy. The primary as- sessment indexes included opertation time, postoperative complications, time of injected analgesic after surgery and postop- erative hospital stay. Results There were no significant differences between the two groups with respect to indicators,oper- tation time （P = 0.103〉0.05）, postoperative complications （P = 0.227〉0.05）, time of injected analgesic after surgery （P = 0.717〉0.05）, postoperative hospital stay （P = 0.545〉0.05）. BMI was associated with opertation time of SA （r = 0.17,P = 0.016〈0.05）. The opertation time was longer in SA with perforated appendicitis （P = 0.005〈0.05）. Conclusion Laparoscop- ic transumbilical single-port appendectomy is safe, feasible and has similar clinical outcomes compared to the conventional laparoscopic three-port appendectomy.