牵拉装置协助下两孔法腹腔镜阑尾切除术的应用体会

The clinical application of laparoscopic traction device for assistance of two ports laparoscopic appendectomy

目的:探讨牵拉装置协助行两孔法腹腔镜阑尾切除术(laparoscopic appendectomy,LA)的手术方法、技巧及临床应用价值。方法:收集2015年7月至2016年7月104例阑尾炎患者的临床资料,其中52例在腹腔镜协助牵拉装置下行两孔法LA(实验组),脐上穿刺10 mm Trocar作为操作孔,耻骨联合阴毛区域穿刺10 mm Trocar作为观察孔,麦氏点置入带线腹腔镜协助牵拉装置协助牵拉阑尾。52例行三孔法LA作为对照组。结果:104例手术均获成功,无一例中转开腹。实验组手术时间明显缩短、患者疼痛感明显减轻、切口总长度减小,两组相比差异有统计学意义(P<0.05)。结论:腹腔镜在牵拉装置协助下行两孔法LA具有手术操作简单、创伤更小、手术时间更短、患者疼痛感更轻、切口美容效果更好等优点,适合临床应用、推广。

Objective：To explore the operative method,technique and clinical application value of two ports laparoscopic appendectomy assisted by laparoscopic traction devices.Methods：One hundred and four cases of appendicitis patients in Tinglin Hospital of Jinshan District from Jul.2015 to Jul.2016 were included and divided into two groups randomly.The laparoscopic appendectomy（n= 52） in research group was carried out through two ports：one Trocar（10 mm） was placed above the navel as operation port and the other one（10 mm） was placed at pubic area as observation port,the laparoscopic traction device was placed at the Mc Burney point.The control group（n = 52） underwent laparoscopic appendectomy with three ports.Results：All the 104 appendectomy surgeries were successfully carried out without conversion to laparotomy.Compared with control group,the research group could shorten the operation time,alleviate patients＇ pain,reduce the total length of incision,the differences between two groups were statistically significant（P〈0.05）.Conclusions：Two ports laparoscopic appendectomy assisted by laparoscopic traction device has advantages such as simpler operation,fewer trauma,shorter operation time,lighter pain,better cosmetic effect,thus is very suitable for clinical application.