腹壁穿刺针辅助经脐单部位腹腔镜小儿阑尾切除术的临床观察

Clinical observation of transumbilical single-site laparoscopic pediatric appendectomy with assistance of abdominal wall puncture needle

目的:探讨腹壁穿刺针辅助经脐单部位腹腔镜小儿阑尾切除术的临床疗效。方法:回顾分析2021年6月至2023年6月收治的120例早期阑尾炎患儿的临床资料,将患儿分为两组,每组60例,观察组采用腹壁穿刺针辅助经脐单部位腹腔镜阑尾切除术,对照组行三孔法传统腹腔镜阑尾切除术,比较两组手术疗效。结果:两组手术均获成功。观察组与对照组手术时间[(30.7±6.2)min vs.(29.9±6.3)min]、术中出血量[(5.8±2.4)mL vs.(5.8±2.0)mL]、住院费用[(10734.5±1243.6)元vs.(10659.4±1155.3)元]差异无统计学意义(P>0.05)。观察组与对照组住院时间[(5.2±1.4)d vs.(6.0±1.3)d]、切口美观评分[(9.0±0.6)vs.(8.1±1.0)]差异有统计学意义(P<0.01)。两组均无切口感染、切口疝、粘连性肠梗阻、盆腔脓肿等并发症发生。结论:腹壁穿刺针辅助经脐单部位腹腔镜阑尾切除术治疗小儿早期阑尾炎具有安全、创伤小、康复快、瘢痕隐蔽、美观等优点,值得临床推广应用。

Objective:To investigate the clinical curative effect of transumbilical single-site laparoscopic pediatric appendec-t omy in the assistance of abdominal wall puncture needle.Methods:Clinical data of 120 children with early appendicitis from Jun.2021 to Jun.2023 were retrospectively analyzed.Patients were divided into two groups with 60 cases in each group,observation group were treated by abdominal wall puncture needle-assisted transumbilical single site laparoscopic appendectomy,control group underwent traditional three-port laparoscopic appendectomy.Surgical efficacy were compared between the two groups.Results:All 120 operations were successful.There was no significant difference between the observation group and control group in operative time[(30.7±6.2)min vs.(29.9±6.3)min,P>0.05],intraoperative blood loss[(5.8±2.4)mL vs.(5.8±2.0)mL,P>0.05],and hospitalization expenses[(10734.5±1243.6)yuan vs.(10659.4±1155.3)yuan,P>0.05];there were significant differences between the observation group and control group in hospital stay[(5.2±1.4)d vs.(6.0±1.3)d,P<0.01]and aesthetic score of the incision[(9.0±0.6)vs.(8.1±1.0),P<0.01].In the two groups no complications occurred such as incision infection,incision hernia,adhesive intestinal obstruction and pelvic abscess.Conclusions:Transumbilical single-site laparoscopic appendectomy with assistance of abdominal wall puncture needle has advantages of safety,mini-invasion,fast recovery,concealed scar,and aesthetics in the treatment of early appendicitis in children,and is worthy of clinical promotion and application.