经脐单孔与传统三孔腹腔镜阑尾切除术的比较

A Comparative Study Between Single-port and Traditional Three-port Laparoscopic Appendectomy

目的探讨经脐单孔腹腔镜阑尾切除术（single-port laparoscopic appendectomy,SPLA）的应用价值。方法2009年7月~2014年12月施行64例SPLA（SPLA组）,与同期84例传统三孔腹腔镜阑尾切除术（three-port laparoscopic appendectomy,TPLA）进行比较,比较2组手术时间、术中出血量、术后排气时间、术后住院时间及并发症。结果 SPLA组手术时间（52.7±12.9）min,与TPLA组（49.2±21.8）min无统计学差异（t=1.124,P=0.263）;SPLA组术中出血量（9.8±6.2）ml,与TPLA组（10.3±7.2）ml无统计学差异（t=-0.438,P=0.662）;SPLA组术后排气时间（19.9±7.4）h,与TPLA组（20.8±6.9）h无统计学差异（t=-0.751,P=0.454）;SPLA组术后住院时间（4.0±0.9）d与TPLA组（3.5±0.8）d有统计学差异（t=3.518,P=0.000）。2组患者术后6个月随访,均无腹腔脓肿、阑尾残端漏、阑尾残株炎及粘连性肠梗阻发生。结论 SPLA安全可行,且具有美观、创伤小等更多优势,值得推广。

Objective To discuss the application value of single-port laparoscopic appendectomy （SPLA）. Methods From July 2009 to December 2014, 64 cases of SPLA were performed, which were compared with 84 cases of three-port laparoscopic appendectomy （TPLA） during the same period. The operation time, intraoperative postoperative hospitalization and complications were compared between the two groups. Results loss, postoperative exhaust time, The operation time was （52.7 ± 12.9） rain in the SPLA group and （49.2± 21.8） rain in the TPLA group, without statistical difference （t = 1. 124, P = 0. 263）. The intraoperative blood loss was （9.8 ± 6.2 ） ml in the SPLA group and （ 10.3± 7.2） ml in the TPLA group, without statistical difference （t= -0.438, P=0.662）. The postoperative exhaust time was （19.9±7.4） bin the SPLA group and （20.8±6.9） h in theTPLA group, without statistical difference （ t = - 0.751, P = 0. 454 ）. The postoperative hospitalization was （4.0 ± 0.9） d in the SPLA group and （3.5 ±0.8） d in the TPLA group, with statistical difference （t = 3. 518, P = 0. 000）. After 6 months of follow-up, there was no intraperitoneal abscess, appendix stump fistula, appendix stump inflammation or adhesive intestinal obstruction in both groups. Conclusion SPLA is safe and feasible, as well as having advantages like good cosmetic results and less trauma, being worthy of popularization.