腹腔镜阑尾切除术阑尾残端处理的方式比较

A Comparison of the Methods of Laparoscopic Appendectomy Applied for the Handling of Appendix Stump

目的:回顾性分析腹腔镜阑尾切除术(LA)几种常用的阑尾残端处理方式的优劣性。方法:LA治疗阑尾炎共352例,根据阑尾残端处理方式分为单纯丝线结扎(A组113例)、单纯套扎线套扎(B组137例)、经丝线结扎或套扎线套扎后加荷包缝合包埋(C组102例),比较三组的手术时间、术中出血量、肠功能恢复时间、住院时间、严重并发症。结果:三组患者手术过程顺利,无中转开腹,荷包缝合包埋组手术时间明显长于单纯丝线结扎组和单纯套扎线结扎组,比较差异有统计学意义(P<0.05);而单纯丝线结扎组与单纯套扎线结扎组手术时间比较差异无统计学意义;三组的术中出血量、肠功能恢复时间、住院时间、严重并发症方面比较差异无统计学意义。结论:LA阑尾残端单纯丝线结扎、单纯套扎线套扎、经丝线结扎或套扎线套扎后加荷包缝合包埋均是安全可靠的,术中可根据阑尾根部情况选择合理的残端处理方式。

Objective：To retrospectively analyze the several common methods of laparoscopic appendectomy （LA） applied for the handling of appendix stump and compare the superiority and inferiority with them.Method：A total of 352 patients of （LA） in the treatment of appendicitis, according to appendix stump processing mode were divided into simple ligation of pure silk （group A, 113 cases）, simple ligation thread ligation （group B, 137 cases）, plus pouch suture embedding after silk thread ligation or ligation thread ligation （group C, 102 cases）, compared the operation time, intraoperative blood loss, bowel function recovery time, hospital stay, complications with the three groups.Result：Three groups operation smoothly, no transfer laparotomy, the operation time of pouch suture embedding group was obviously longer than pure silk thread ligation group and simple ligation thread ligation group （P〈0.05）, but the operation time of pure silk ligation group and simple ligation thread ligation group was not statistically significant, intraoperative blood loss, bowel function recovery time, hospital stay, differences of serious complications of the three groups were not statistical significant.Conclusion：Simple ligation of pure silk, simple ligation thread ligation and plus pouch suture embedding after silk thread ligation or ligation thread ligation all are safe and reliable applied for the handling of appendix stump, the most reasonable treatment is in according to the residual root of appendix.