腹腔镜手术治疗小儿阑尾周围脓肿的可行性探索

Feasibility of laparoscopic operation for pediatric periappendiceal abscess

目的:探讨腹腔镜阑尾周围脓肿切除术治疗小儿阑尾周围脓肿的可行性。方法:回顾分析2019年1月至2021年12月采用腹腔镜阑尾周围脓肿切除术治疗的31例阑尾周围脓肿患儿(脓肿组)及同期收治的78例非脓肿性阑尾炎患儿(对照组)的临床资料,对比分析两组手术时间、住院时间、腹腔引流量、住院花费、肠道通气时间、术后并发症等相关指标。结果:两组均顺利完成手术,无中转开腹及死亡病例。脓肿组与对照组患儿发病年龄[(7.65±2.21)岁vs.(9.04±2.50)岁]、手术时间[(78.19±8.09)min vs.(58.74±8.25)min]、住院时间[(8.45±1.57)d vs.(7.55±0.75)d]、术后腹腔引流量[(100.32±19.91)mL vs.(24.36±7.95)mL]、住院总费用[(1.39±0.13)万vs.(1.21±0.15)万]差异有统计学意义(P<0.05);两组术前白细胞[(13.14±2.86)×10^(9)/L vs.(12.88±1.97)×10^(9)/L]、术后肠道排气时间[(2.29±0.64)d vs.(2.47±0.69)d]、术后切口感染情况(2 vs.5)差异无统计学意义(P>0.05)。结论:腹腔镜阑尾周围脓肿切除术治疗小儿阑尾周围脓肿是安全、可行的,值得推广。

Objective:To investigate the feasibility of laparoscopic resection of periappendiceal abscess in the treatment of pe-diatric periappendiceal abscess.Methods:The clinical data of 31 children with periappendiceal abscess(abscess group)and 78 children with non-abscess appendicitis(control group)treated by laparoscopic resection from Jan.2019 to Dec.2021 were retrospectively analyzed.The operation time,hospitalization time,abdominal drainage volume,hospitalization cost,intestinal ventilation time and postoperative complications were compared between the two groups.Results:Operations were successfully completed in both groups without conversion to laparotomy or death cases.Compared with the control group,the abscess group showed significant differences(P<0.05)in age of onset[(7.65±2.21)years vs.(9.04±2.50)years],operation time[(78.19±8.09)min vs.(58.74±8.25)min],hospital stay[(8.45±1.57)d vs.(7.55±0.75)d],postoperative abdominal drainage volume[(100.32±19.91)mL vs.(24.36±7.95)mL]and total hospitalization cost[(1.39±0.13)ten thousand vs.(1.21±0.15)ten thousand].However,in terms of preoperative white blood cell value[(13.14±2.86)×10^(9)/L vs.(12.88±1.97)×10^(9)/L],postoperative intestinal exhaust time[(2.29±0.64)d vs.(2.47±0.69)d],and postoperative incision infection(2 vs.5),there was no significant difference between the two groups(P>0.05).C onclusions:Laparoscopic periappendiceal abscess resection is safe and feasible in children with periappendiceal abscess,which is worthy of promotion.