经脐单孔腹腔镜在小儿急性阑尾炎手术中的应用

Application of transumbilical single-hole laparoscopy in acute appendicitis operation in children

目的探讨经脐单孔腹腔镜在小儿急性阑尾炎手术中的应用。方法回顾性分析60例急性阑尾炎患儿的临床资料,其中经脐单孔腹腔镜手术28例,三孔腹腔镜手术32例,术后随访6~12个月,分析经脐单孔腹腔镜手术的治疗效果。结果经脐单孔腹腔镜组的手术时间、术后肛门排气时间、术后住院时间及手术费用均低于三孔腹腔镜组,差异有统计学意义(P<0.05)。2组患儿切口均为甲级愈合,经脐单孔腹腔镜组术后瘢痕数少于三孔腹腔镜组。2组术后随访6~12个月,单孔腹腔镜组中无腹腔脓肿及肠梗阻发生;三孔腹腔镜组中1例患儿发生术后腹腔脓肿,2例发生粘连性肠梗阻。结论经脐单孔腹腔镜下阑尾切除术较三孔腹腔镜下阑尾切除术,手术简单、有效且美容效果好,花费低,值得临床应用。

Objective To explore the application of transumbilical single-hole laparoscopy in children with acute appendicitis.Methods The clinical data of 60 children with acute appendicitis were retrospectively analyzed,including 28 cases of transumbilical single-hole laparoscopic surgery and 32 cases of three-hole laparoscopic surgery.Results The operation time,postoperative flatus time,postoperative hospital stay and operation cost in the trans-umbilical single-hole laparoscopic group were all lower than those in the three-hole laparoscopic group,with statistically significant differences(P<0.05). The incisions of the two groups were grade a healing,and the number of postoperative scars was less than those of the three-hole laparoscopic group. The two groups were followed up for 6~12 months. No abdominal abscess or intestinal obstruction occurred in the single-hole laparoscopic group. In the three-hole laparoscopy group,and one case of postoperative abdominal abscess and two cases of adhesive intestinal obstruction occurred.Conclusion Comparing with three-hole laparoscopic appendectomy,single hole laparoscopic appendectomy is simple,effective and has good cosmetic effect.