经脐单孔与常规腹腔镜阑尾切除术的疗效比较

Comparison of the curative effect of transumbilical single hole and routine laparoscope appendectomy

目的：比较经脐单孔与常规腹腔镜阑尾切除术的疗效。方法80例急性阑尾炎患者按手术方式分为单孔组40例与常规组40例，分别采用经脐单孔腹腔镜阑尾切除术与常规腹腔镜阑尾切除术，比较两组临床疗效。结果两组手术均成功，无中转开腹手术。单孔组患者术后肛门排气时间[（21．7±6．2）h]明显短于常规组[（26．9±7．3）h]（t＝2．18，P＜0．05），但两组手术时间、术中出血量、术后住院时间和术中术后并发症差异均无统计学意义（均P＞0．05）。术后随访3～21个月，均未发现阑尾残株炎、阑尾残端瘘、肠粘连梗阻等远期并发症。结论经脐单孔腹腔镜阑尾切除术具有安全、微创的优点，术后肠功能恢复快，美容效果好。当阑尾切除困难时，应视阑尾病变情况采取相应手术技巧，能有效减少并发症发生。

Objective To compare the curative effect of transumbilical single port laparoscopic appendectomy and conventional laparoscope appendectomy .Methods 80 cases with acute appendicitis were divided into single hole group and routine group according to the operation mode ,40 cases in each group .The two groups were given transum-bilical single port laparoscopic appendectomy and conventional laparoscopic appendectomy ,respectively.The clinical efficacy was compared between the two groups .Results The patients in two groups were given successful operation without converted laparotomy .The postoperative anal exhaust time of the single hole group was （21.7 ±6.2）h,which was significantly shorter than that in the routine group [（26.9 ±7.3）h]（t=2.18,P〈0.05）.However,the operation time,intraoperative bleeding amount ,postoperative length of stay ,intraoperative and postoperative complication had no obviously statistical differences between two groups （P〉0.05）.The patients were followed up for 3-21 months,no appendix stump inflammation , appendiceal stump fistula , adhesive ileus and other remote complication appeared . Conclusion Transumbilical single hole has safe and minimal invasive advantages on appendectomy , which can be favorable for the postoperative recovery of bowel function and cosmetic result .If it′s difficult to excise appendix , relevant operation skills shall be applied in accordance with the appendiceal lesions ,which can effectively reduce the occurrence of complication .