隐疤痕腹腔镜阑尾切除术与经典术式的对比研究

Comparative study of hidden scars laparoscopic appendectomy and classic operation

目的:探讨隐疤痕腹腔镜阑尾切除术(laparoscopic appendectomy,LA)的可行性,并与经典LA进行对比研究。方法:回顾分析2012年9月至2013年9月81例LA患者的临床资料,其中41例行隐疤痕LA(隐疤痕组),40例行经典LA(经典组),对比分析两组患者手术时间、术中出血量、术后胃肠功能恢复时间、下床活动时间、术后住院时间、并发症等指标。结果:81例手术均获成功,无一例中转开腹,术中、术后均无严重并发症发生。两组患者手术时间、术中出血量、下床活动时间、胃肠功能恢复时间、术后住院时间、术后疼痛评分差异无统计学意义(P>0.05)。随访显示,隐瘢痕组美容效果更满意。结论:隐疤痕LA的安全性、有效性与经典LA相比无显著差异,但其美容效果更佳。对于明显肥胖、诊断不明、需同时处理其他腹腔疾病的患者,隐疤痕LA受到一定限制。

Objective：To explore the feasibility of hidden scars laparoscopic appendectomy （LA） and compare it with classic operation. Methods：The clinical data of 81 patients who underwent LA from Sep. 2012 to Sep. 2013 were retrospectively analyzed. 41 patients underwent hidden scars LA and 40 patients underwent classic LA. The two groups were compared with operative time, intraoperative blood loss, postoperative recovery time of gastrointestinal function, ambulation time, postoperative hospital stay and complications. Results：All of the operations were performed successfully. There were no severe complications during and after operation. No one was converted to open surgery. In the hidden scars LA group, operating time, blood loss, postoperative ambulatio^h time, postoperative intesti- nal function recovery time, postoperative hospital stay and pain score were （44 ± 6 ） min, （：2.2± 0.6） ml, （ 18.0 ± 1.1 ） h, （22 ± 4） h, （3.4± 1.1 ） d, （2.0 ±1.0）. The data in the classic LA group were （36 ± 5 ） rain, （2.5 ± 0.5） ml, （ 16.0± 2.1 ） h, （24 ± 5） h, （3.8±0. 9） d, （2.0 ±0.0）. There were no significant differences between two groups （P 〉0.05）i. The cosmetic results of the hidden scars LA group were better than the classic group. Conclusions：Hidden scars LA is as safe and efficient as classic operation, and brings more obvious cosmetic results than classic operation. But for apparently obese patients, or patients whose diagnoses are still unknown or other abdominal diseases should be treated at the same time, hidden scars LA is limited.