腹腔镜阑尾切除术4450例分析

Clinical analysis of laparoscopic appendectomy:a report of 4450 cases

目的总结腹腔镜阑尾切除术(laparoscopic appendectomy,LA)的临床应用价值。方法行腹腔镜阑尾切除术患者4450例。采用三孔法操作,阑尾系膜单极电凝,体外打结结扎阑尾根部,简易标本袋取出阑尾。结果 4413例成功完成LA,37例中转开腹,手术时间18~190分钟,平均(56.00±15.50)分钟;术中出血2~35 ml,平均(10.0±5.5)ml;术后住院1~12天,平均4.2天。术后切口感染10例,术后肠梗阻及术中肠道损伤各1例,无术后肠漏、残端瘘、腹腔脓肿、切口疝等手术并发症。结论 LA治疗阑尾炎安全、有效,创伤小,痛苦轻,术后住院时间短,康复快,并发症少。

Objective To study the clinical application value of laparoscopic appendectomy（ LA）. Methods The clinical data of 4450 patients performed LA were analyzed retrospectively. The surgery were performed with three-port laparoscopy,monopolar coagulation with the mesoappendix,and extra abdominal ligation of the appendix root,the appendix was removed by simple specimen bag. Results The procedure was successfully accomplished in 4413 case,while 37 cases were converted to laparotomy. The operating time was 18 ~ 190 min,mean（ 56. 00 ± 15. 50） min. The blood lost was 2 ~ 35 ml,mean（ 10. 0 ±5. 5） ml. The postoperative hospital stay was1 ~ 12 d,mean 4. 2 d. 10 cases occurred incisional infection,postoperative ileus and intraoperative bowel injury occured in 1 case respectively. No intestinal fistula,appendix stump fistula,intra abdominal abscess and incisional hernia were found during follow up time. Conclusion LA is a safe surgery and effective for appendicitis with advantages such as less trauma,less pain,shorter hospital stay,faster recovery and less complications.