传统器械行改良单孔腹腔镜阑尾切除术的应用体会

Application experience of modified single hole laparoscopic appendectomy with traditional instruments

目的总结传统器械行改良单孔腹腔镜阑尾切除术的应用体会。方法选取60例应用传统器械行单孔腹腔镜阑尾切除术的患者作为观察组,另选择同期37例行常规经脐腹腔镜阑尾切除术的患者作为对照组。比较两组患者的手术相关指标及并发症发生情况。结果观察组手术时间为(29.4±8.2)min,明显短于对照组的(33.8±10.5)min,差异具有统计学意义(P<0.05)。两组患者术中出血量、肛门排气时间、术后6 h视觉模拟评分(VAS)、住院时间和住院费用比较,差异无统计学意义(P>0.05)。两组并发症发生率比较,差异无统计学意义(χ2=3.312,P=0.069>0.05)。结论传统器械行改良单孔腹腔镜阑尾切除术中缩短的小穿刺器和单人单手打结法的应用可在保留传统腹腔镜技术操作优势的基础上进一步避免器械冲突问题的发生,其操作更简单,可突出微创手术的优点,值得临床推广应用。

Objective To summarize the application experience of traditional instruments in the modified single hole laparoscopic appendectomy. Methods A total of 60 patients who underwent modified single hole laparoscopic appendectomy with traditional instruments were selected as observation group, another 37 patients who underwent conventional transumbilical laparoscopic appendectomy were selected as control group. The operative related indicators and occurrence of complications of the two groups were compared. Results The operative time of the observation group was（29.4±8.2） min, which was significantly shorter than（33.8±10.5） min of the control group, the difference was statistically significant（P〈0.05）. There were no significant differences in the intraoperative blood loss, anal exhaust time, visual analogue scale（VAS）, length of stay and hospitalization expenses between the two groups（P〉0.05）. There was no significant difference in the incidence of complications between the two groups（χ^2=3.312, P=0.069〉0.05）. Conclusion The application of the shortened Mini-Puncture apparatus and single-hand knotting method in the modified single hole laparoscopic appendectomy with traditional instruments can further avoid the occurrence of instrument conflicts on the basis of reserving the advantages of traditional laparoscopic techniques. The operation is simpler and can highlight the advantages of minimally invasive surgery. It is worthy of clinical promotion and application.