经脐单孔腹腔镜阑尾切除术治疗慢性阑尾炎58例

Transumbilical single-port laparoscopic appendectomy for chronic appendicitis： a report of 58 cases MENG

目的探讨单孔腹腔镜阑尾切除术治疗慢性阑尾炎的安全性和可行性。方法回顾性分析北京中日友好医院2010年1月至2012年11月同一术者行腹腔镜阑尾切除术治疗慢性阑尾炎共计121例，其中单孔腹腔镜阑尾切除术58例，三孔腹腔镜阑尾切除术63例，比较分析两组的临床资料。结果与三孔腹腔镜组比较，单孔腹腔镜组切口满意度得分较高，（4．5±0．7）比（3．0±0．6），t=13．50，P=0．00；术后对止痛药的需求次数较少，（1．2±0．5）次比（2．1±0．7）次，t=-8．25，P=0．00；手术时间未增加，（40±10）min比（37±9）min，t=1．94，P=0．055；失血量未增多，（12±6）ml比（13±6）ml，t=-1．50，P=0．137；术后住院时间无差异，（1．4±0．6）d比（1．6±0．7）d，t=-1．82，P=0．072。全组在围手术期均无手术并发症发生。结论单孔腹腔镜阑尾切除术安全可行，与常规三孔腹腔镜手术有相似的临床效果。

Objective To evaluate the safety and feasibility of single-port laparoscopic surgery （SPLS） for chronic appendicitis. Methods Data of patients who had undergone either conventional threeport surgery （ n = 58） or SPLS （ n = 63 ） for chronic appendicitis between January 2010 and November 2012 were analyzed retrospectively. The short-term outcomes of these 2 operative modalities were compared. Results The overall satisfaction score of SPLS group was significantly higher than that of the three-port group （4. 5 ±0. 7） vs. （3.0-±0. 6） ,t = 13.50,P =0. 00, there was less frequent use of parenteral narcotics in SPLS patients （ 1.2± 0. 5） vs. （2. 1 ± 0. 7） times, t = - 8.25,P = 0. 00, length of operation time was the same in SPLS group （40 ± 10） vs. （37 ±9） minutes, t = 1.94, P =0. 055. There was not different in postoperative recovery （1.4 ± 0.6） vs. （1.6 ± 0.7） d, t = - 1.82,P = 0.072, nor different in perioperative complications and intraoperative blood loss between groups （ 12 ± 6 ） vs. （ 13 ± 6 ） ml, t = - 1.50,P = 0. 137. Conclusions SPLS is both safe and feasible in the treatment of chronic appendicitis.