三孔法腹腔镜阑尾切除术腹壁切口选择体会

The choice of abdominal ports in laparoscopic appendectomy by using a three port technique

目的 从美容的观点探讨三孔法腹腔镜阑尾切除术腹壁戳孔的最佳位置。方法 回顾性分析腹腔镜阑尾切除术 3 91例的三组不同腹壁戳孔 (三个切口分别为 10、10、5mm)手术的优缺点。第 1组在脐与左侧髂前上棘连线中外 1 3处内侧 2cm和腹正中线耻骨上 4cm处 ;第 2组脐与左侧髂前上棘连线中外 1 3和麦氏点头侧 4cm处 ;第 3组耻骨结节左、右侧各 1cm处 ,分析位置选择的优缺点。结果 除手术时间不同外 (P <0 .0 5 ) ,平均住院天数、切口感染率、中转开腹率均无统计学差异 (P >0 .0 5 )。结论 在腹腔镜阑尾切除术中 ,应在保证手术安全的情况下 ,尽可能采用双耻骨上戳孔 ,以获得最佳的美容效果。

Objective To investigate the best way of making abdominal ports in laparoscopic appendectomy by using a three port technique from the cosmetic perspective.Methods Three different approaches in 3 groups including 391 cases of laparoscopic appendectomy were compared in a retrospective study (The 3 incisions were 10 mm,10 mm and 5 mm).Group 1:the incisions were chosen in 2 cm inside the junction of the middle and outer thirds of a line joining the umbilicus to the left anterior superior iliac spine and 4 cm on the pubis in the middle line;group 2:the ports were located at the junction of the middle and outer thirds of a line joining the umbilicus to the left anterior superior iliac spine and 4 cm upon the McBurney's point;Group 3;the incisions were 1 cm left and right respectively to the pubic tuberde.Results Except that the operation time was different significantly (P<0.05),there were no diffferences in mean hospitalization time,infectious rate of incisions and conversion open operation statistically (P>0.05).Conclusion In laparoscopic appendectomy,double suprapubic ports should be adopted based on the best cosmetic perspective.