腹腔镜逆行阑尾切除与顺行阑尾切除疗效对比研究

Effect comparative study of laparoscopic retrograde appendectomy and anterograde appendectomy

目的对比腹腔镜逆行阑尾切除术与顺行阑尾切除术的临床效果。方法选择2014年5月至2016年7月咸阳市中心医院普通外科收治的312例需行手术的急性阑尾炎患者,按照手术方式的不同分为观察组与对照组。观察组153例患者采用腹腔镜逆行法切除阑尾,对照组159例患者采用腹腔镜顺行法切除阑尾,对比两组患者的手术时间、术后进食时间、住院时间、肛门排气时间、并发症发生率及术中中转开腹率。结果两组患者的手术时间、术后进食时间、平均住院时间、肛门排气时间及术后并发症发生率比较,差异均无统计学意义(P>0.05);观察组中转开腹率明显低于对照组(P<0.05)。结论腹腔镜逆行阑尾切除术可取得与腹腔镜顺行阑尾切除术同样满意的效果,且可明显降低术中中转开腹率,值得推广。

Objective To compare ihe clinical effect of laparoscopic retrograde appendectomy and anterograde appendectomy. Methods Three hundred and twelve cases of palienls with acute appendicilis undergo surgery in deparlmenl of general surgery of Xianyang Central Hospital from May 2014 to July 2016 were selected and divided into observation group and control group according lo different surgical methods. 153 cases in lhe observation group were treated with laparoscopic retrograde appendectomy, while 159 cases in lhe control group were treated with laparoscopic anterograde method lo remove lhe appendix. The operation lime, postoperative eating lime, length of hospilal slay, postoperative anal exhaust lime, incidence of complications and conversion lo open laparotomy were compared between lhe lwo groups. Results There was no significant difference in operation lime, average postoperative eating lime, average hospitalization lime, anal exhaust lime and postoperative complication rale between lhe lwo groups （P 〉0.05）; lhe incidence rale of conversion lo open laparotomy in lhe observation group was significantly lower than lhal in lhe control group （ P 〈0.05）. Conclusion Laparoscopic retrograde appendectomy can achieve lhe same satisfactory effect as laparoscopic appendectomy, and significantly reduce intraoperative diversion rale, whichis worth promoting.