腹腔镜阑尾切除术中阑尾根部结扎与Hem-o-lok夹闭的对比研究

Comparison study of ligation and Hem-o-lok in securing of appendix stump in laparoscopic appendectomy

目的探讨阑尾根部结扎在腹腔镜阑尾切除术(LA)中的应用价值。方法 2016年6月～2017年12月因急性阑尾炎行LA 105例,采用两种不同方法处理阑尾残端,53例阑尾根部行丝线结扎,52例用Hem-o-lok夹闭阑尾根部,比较两组手术时间和术后恢复情况。结果两组术后并发症、术后住院时间比较差异无统计学意义(P> 0. 05)。结扎组手术时间(55. 5±7. 8)分钟,Hem-o-lok组(46. 1±5. 6)分钟;结扎组阑尾根部处理费用0. 3元,Hem-o-lok组560元。两组比较差异具有统计学意义(P <0. 05)。结论两种处理阑尾残端的方法均安全、有效,但结扎组手术费用较少。Hem-o-lok夹闭阑尾根部节省手术时间,操作简单,更适合于初学者。

Objective To compare ligation and Hem-o-lok in securing of appendix stump in laparoscopic appendectomy. Methods There were 105 patients undergoing laparoscopic appendectomy. They were treated by two different methods in securing of the base of the appendix: silk ligation of the stump was performed in 53 cases( ligation group);while stump ligation by using Hem-o-lok clips was performed in52 cases( Hemlock group). Two groups were compared in operation time and post-operative patient recovery. Results Between the both groups,postoperative complications and postoperative hospital stay had no significant differences( P > 0. 05). The operation time of the ligation group was( 55. 5 ± 7. 8) min,which was significantly longer than that of the Hem-o-lok group[( 46. 1 ± 5. 6) min,( P < 0. 05) ]. The cost of appendix root treatment in the ligation group was 0. 3 yuan,while the cost in Hem-o-lok group was 560 yuan. The difference between the two groups was statistically significant( P < 0. 05). Conclusion Both methods are safe and effective in securing of the base of the appendix in laparoscopic appendectomy.Purse-string suture is more in line with traditional appendectomy requirements and cost effective,but requiring more skilled laparoscopic manipulation. Hem-o-lok clipping of the appendix saves operation time and is easy to perform,which is more suitable for beginners.