单孔腹腔镜与多孔腹腔镜手术治疗小儿阑尾炎的对比分析

Comparison of single- port laparoscopic appendectomy and mult- port laparoscopic appendectomy in children with appendicitis

目的 比较单孔腹腔镜与多孔腹腔镜手术在小儿阑尾切除术中的临床疗效。方法 回顾性分析96例行腹腔镜阑尾切除术患儿的临床资料，其中48例行单孔腹腔镜手术（观察组），48例行多孔腹腔镜手术（对照组）。比较两组手术时间、术中出血量、术后排气时间、术后住院时间、切口长度及手术相关并发症等。结果 患儿均顺利完成腹腔镜手术。两组术中出血量和术后住院时间比较差异无统计学意义（P〉0.05）；观察组手术时间、术后排气时间和切口长度明显低于对照组[（19.8 ± 5.3）min比（30.2 ± 8.1）min、（15.6 ± 4.7）h比（22.7 ± 6.5）h和（1.1 ± 0.2）cm比（2.3 ± 0.4）cm]，差异有统计学意义（P〈0.01）。观察组1例发生切口感染，经对症治疗后痊愈，两组未发生其他术中、术后并发症，所有患儿恢复顺利。结论 单孔腹腔镜手术治疗小儿阑尾炎安全可行，手术时间短，胃肠功能恢复快，并且美容效果更好。

Objective To compare the clinical effect of single-port laparoscopic appendectomy and traditional mult-port laparoscopic appendectomy in children with appendicitis.Methods The clinical data of 96 appendicitis children who had underwent laparoscopic appendectomy were retrospectively analyzed. Among the children, 48 children received single-port laparoscopic appendectomy （observation group）, and 48 children received mult-port laparoscopic appendectomy （control group）. The operation time, blood loss, postoperative exhaust time, postoperative hospital stay, incision length and surgery-related complications between 2 groups were compared.Results All children were operated successfully. There were no statistical differences in blood loss and postoperative hospital stay between 2 groups （P〉0.05）. The operation time, postoperative exhaust time and incision lengths in observation group were significantly lower than those in control group： （19.8 ± 5.3） min vs. （30.2 ± 8.1） min, （15.6 ± 4.7） h vs. （22.7 ± 6.5） h and （1.1 ± 0.2） cm vs. （2.3 ± 0.4） cm, and there were statistical differences （P〈0.01）. There was 1 case with incision infection in observation group, and the child was cured after symptomatic treatment. There was no other surgery-related complication in 2 groups, and all children recovered smoothly.Conclusions The single-port laparoscopic appendectomy is safe and feasible in children with appendicitis. It has short operation time, fast recovery of gastrointestinal function, and better cosmetic effect.