单孔与传统腹腔镜治疗老年急性阑尾炎的临床研究

Clinical study of single port and traditional laparoscopic treatment of acute appendicitis in the elderly

目的比较单孔腹腔镜与传统腹腔镜治疗老年(≥60岁)急性阑尾炎的效果,探讨单孔腹腔镜阑尾切除术对老年患者的可行性。方法110例老年急性阑尾炎患者,根据手术方法不同分为单孔组和传统组,每组55例。单孔组患者采用单孔腹腔镜阑尾切除术治疗,传统组患者采用传统腹腔镜阑尾切除术治疗。比较两组手术时间、术中出血量、术后肠道功能恢复时间、住院时间、术后抗生素使用时间,中转开腹、术后并发症发生情况,不同类型急性阑尾炎手术时间。结果两组术中出血量、术后肠道功能恢复时间、住院时间及术后抗生素使用时间比较,差异无统计学意义(P>0.05);单孔组手术时间(62.47±33.49)min长于传统组的(50.76±15.14)min,差异有统计学意义(P<0.05)。两组无中转开腹患者;两组术后并发症发生率比较差异无统计学意义(P>0.05)。单孔组与传统组单纯性急性阑尾炎的手术时间比较差异无统计学意义(P>0.05);单孔组复杂性急性阑尾炎的手术时间(88.89±43.81)min长于传统组的(53.11±13.04)min,差异有统计学意义(P<0.05)。结论单孔腹腔镜治疗老年单纯性急性阑尾炎具有创伤小、恢复快、出血少、住院时间短等优点,且更加美观;单孔腹腔镜治疗老年复杂性急性阑尾炎同样安全有效,但手术时间长。

Objective To compare the effects of single-port laparoscopic and traditional laparoscopic treatment of acute appendicitis in elderly patients(≥60 years old),and to discuss the feasibility of singleport laparoscopic appendectomy for elderly patients.Methods 110 elderly patients with acute appendicitis were divided into the single-port group and the traditional group,with 55 cases in each group.The patients in the single-port group were treated with single-port laparoscopic appendectomy,and the patients in the traditional group were treated with traditional laparoscopic appendectomy.The operation time,intraoperative bleeding,postoperative intestinal function recovery time,hospital stay,postoperative antibiotic use time,conversion to laparotomy,postoperative complications and operation time for patients with different types of acute appendicitis were compared between the two groups.Results The differences in intraoperative bleeding,postoperative intestinal function recovery time,hospital stay and postoperative antibiotic use time between the two groups were not statistically significant(P>0.05).The operation time of single-port group was(62.47±33.49)min,which was longer than(50.76±15.14)min of the traditional group,and the difference was statistically significant(P<0.05).There was no conversion to laparotomy in the two groups.The difference in the incidence of postoperative complications between the two groups was not statistically significant(P>0.05).The difference in the operation time of acute simple appendicitis between the single-port group and the traditional group was not statistically significant(P>0.05);while the operation time of complicated acute appendicitis in single-port group was(88.89±43.81)min,which was longer than(53.11±13.04)min of the traditional group,and the difference was statistically significant(P<0.05).Conclusion Single-port laparoscopic treatment of acute simple appendicitis in elderly patients has the advantages,such as less trauma,quick recovery,less bleeding,short hospital stay,and shows beautiful appearance.Single-port laparoscopic treatment of complicated acute appendicitis in elderly patients is also safe and effective,but the operation time is relatively long.