经脐单孔腹腔镜在成人急性阑尾炎手术中的应用研究

Application of Tranumbilical Single-port Laparoscopy in the Operation of Adult Acute Appendicitis

目的:探讨经脐单孔腹腔镜技术(LESS)用于成人急性阑尾炎的益处和可行性。方法:选取我院30例行单孔腹腔镜下阑尾炎患者为观察组,并与同期30例传统多孔腹腔镜下阑尾炎患者对照,观察两组手术时间、术中出血量、胃肠功能恢复时间、住院时间及总费用、手术并发症、术后镇痛药物使用时间、术后24 h疼痛视觉模拟评分(visual analogue scale,VAS)、术后体象量表(body Image Scale,BIS)及美容评分(cosmetic score,CS)等。结果:两组患者手术时间、术中出血量、总费用、手术并发症、体象量表方面,差异无统计学意义(P>0.05);而在胃肠功能恢复时间、总住院时间及止痛药使用时间、VAS、美容评分方面差异有统计学意义(P<0.05)。结论:经脐单孔腹腔镜可以有效缩短术后排气时间、住院时间及止痛药使用时间,且术后患者疼痛较轻,达到无疤效果,提高患者美观满意度,在年轻患者中更具有潜在的应用空间。

Objective To explore the benefits and feasibility of transumbilical single-port laparoscopy( LESS) for adult acute appendicitis. Methods Thirty patients with appendicitis under single-port laparoscopy in our hospital were selected as observation group and 30 patients with appendicitis under traditional porous laparoscopy in the same period were compared.The operation time,intraoperative bleeding volume,recovery time of gastrointestinal function,hospital stay and total cost,operative complications,use time of analgesics after operation,visual analogue score( VAS) of pain 24 hours after operation were observed in the two groups. Results There was no statistically significant difference in surgical complications,body image scale,operation time,total cost and intraoperative blood loss between the two groups( P > 0. 05),but there were statistically significant differences in gastrointestinal function recovery time,total hospitalization time,analgesic use time,VAS and cosmetic score( P<0.05). Conclusion Transumbilical single-port laparoscopy can effectively shorten gastrointestinal function recovery time,hospitalization time and analgesic use time. Postoperative patients have light pain,achieve no scar effect,improve the aesthetic satisfaction and have more potential application space especially in young patients.