腹腔镜阑尾切除术治疗阑尾炎490例临床体会

Clinical experience of 490 patients with appendicitis treated by laparoscopic appendectomy

目的探讨腹腔镜阑尾切除术的临床应用体会。方法回顾性分析2005年3月至2013年3月行腹腔镜阑尾切除术治疗的490例阑尾炎患者的临床资料,其中单纯性阑尾炎289例,化脓及坏疽穿孔性阑尾炎120例,阑尾周围脓肿11例,慢性阑尾炎70例。结果手术顺利完成472例,18例中转开腹,3例切口感染,无其他并发症发生。398例获得门诊或电话随访,随访时间3-60个月,无肠瘘、阑尾残株炎、残余脓肿、粘连性肠梗阻、切口疝等手术并发症发生。结论腹腔镜阑尾切除术安全、有效、创伤小、痛苦轻,术后住院时间短、康复快、并发症少等优点,目前已经逐渐成为进行阑尾切除的首选方法,值得临床推广应用。

Objective To study the clinical experience of laparoscopic appendectomy（LA）. Methods A retrospective analysis was conducted on the clinical data of 490 patients with appendicitis,who underwent LA from March 2005 to March 2013,including 289 cases of simple appendicitis,120 cases of suppurative appendicitis and gangrenous perforated appendicitis, 11 cases of appendiceal abscess,and 70 cases of chronic appendicitis. Results The operation was smoothly completed in 472 cases,and the other 18 cases were converted to laparotomy,including 3 cases of incision infection without other complications. A total of 398 patients were with 3-60-month follow up,no intestinal fistula,appendix stump inflammation, residual abscess,adhesive intestinal obstruction,incisional hernia and other complications occurred. Conclusion LA is safe and effective for appendicitis,with advantages of minimal trauma,lighter pain,quicker recovery,shorter hospital stay,less complications and so on. Currently it has become the preferred method for appendectomy, and it is worthy of popularization and promotion.