重度肥胖患者行腹腔镜阑尾切除术的临床体会(附26例报告)

Clinical experience of laparoscopic appendectomy for severely obese patients:with a report of 26 cases

目的:探讨为重度肥胖患者行腹腔镜阑尾切除术(laparoscopic appendectomy,LA)的可行性。方法:回顾分析为26例重度肥胖患者行LA的临床资料。结果:26例均顺利完成手术,21例采用三孔法,5例采用四孔法;手术时间36～85 min,平均(41.2±12.6)min,无一例中转开腹,术中无大出血或肠管损伤等并发症发生。术后住院2～5 d,平均(2.7±1.6)d。结论:重度肥胖患者行LA是安全、有效的,手术操作较标准体重患者困难,对术者技术要求更高。

Objective：To investigate the feasibility of laparoscopic appendectomy （LA） for severely obese patients. Methods： Retrospective analysis was made on the clinical data of 26 severely obese patients who underwent LA. Results：All operations were suc- cessfully performed without conversion to laparotomy. No intra-operative massive hemorrhage, small bowel obstruction or postoperative intestinal leakage were observed. 21 patients used three Trocars during operations while 5 patients used four Trocars. The operation time ranged from 36 to 85 rain, （41.2 ± 12.6） min on average. Postoperative hospital stay was 2-5 d,the mean was （2.7 ± 1.6） d. Conclu- sions：LA for severely obese patients is safe and effective. The operation procedure is more difficult and needs more skillful specialist than normal operation for normal weight patients.