阑尾炎再手术20例分析

Analysis of 20 cases of post-appendectomy reoperation.

目的 探讨预防或减少阑尾炎再手术的措施和手术方法。方法 对 1999年 1月至 2 0 0 1年 1月收治的急性阑尾炎因各种原因施行再手术 2 0例进行回顾性分析。结果 2 0例再手术者因结肠肿瘤而漏诊 7例 ,其它疾病误诊 4例 ;因明显技术操作不当致再手术 4例 ,其中 2例表现为失血性休克 ,1例阑尾残株炎 ,1例腹壁下动脉损伤 ;术后并发症 5例 ,其中腹壁窦道 2例 ,粪瘘 1例 ,腹膜外脓肿 1例 ,盆腔脓肿 1例。结论 掌握外科基本功 ,遵循外科基本原则 ;避免惯性思维 ,减少误诊机会 ,常能够避免或减少阑尾炎再手术的机率。

Objective To explore the procedures and methods of preventing or decreasing post-appendectomy reoperation rate. Methods Tweny cases hospitalized from January 1999 to January 2001 for various causes of post appendectomy reoperation were analyzed retrospectively.Results In 20 cases,7 were colonic cancers and 4 were other diseases, instead of appendicitis.Four patients received reoperation for obvious technical errors,2 of them were due to manifested hemorrhagic shock,1 stump appendicitis,1 inferior abdominal artery injury.Five patients had complications,among them 1 was fistula of abdominal wall,1 fecal fistula,1 extraperitoneal abscess,1 pelvic abscess.Conclusion The key for preventing or decreasing post-appendectomy reoperation is mastering the basic surgical techniques and rationale,avoiding habitual way of thinking.