BACKGROUND Because of the mild inflammatory status in acute uncomplicated appendicitis,our team developed a novel technical protocol for single-port laparoscopic appendec-tomy using needle-type grasping forceps(SLAN)a...BACKGROUND Because of the mild inflammatory status in acute uncomplicated appendicitis,our team developed a novel technical protocol for single-port laparoscopic appendec-tomy using needle-type grasping forceps(SLAN)and achieved positive clinical outcomes.However,the intraoperative procedure lacked stability and fluency due to a series of problems highlighted by the small incision design of the proto-col(only 1 cm long).Therefore,there is a growing clinical demand to further opti-mize the SLAN protocol.CASE SUMMARY An adult male patient was admitted for persistent right lower abdominal pain with preoperative computed tomography findings suggestive of appendicitis accompanied by localized peritonitis.A modified technical protocol for SLAN based on minimally invasive surgical principles was used,and the patient was confirmed to have acute simple appendicitis by postoperative pathological ana-lysis.Postoperative recovery was uneventful,and no postoperative complications,such as incision infection or severe incision pain,were observed.The patient was discharged successfully on postoperative day 2.CONCLUSION The modified technical protocol of SLAN may be a new minimally invasive surgical alternative for patients with acute simple appendicitis.展开更多
Introduction: Acute appendicitis represents an urgent surgical condition, requiring the removal of the vermiform appendix. Laparoscopy is the standard surgical approach. This study aimed to outline the epidemiological...Introduction: Acute appendicitis represents an urgent surgical condition, requiring the removal of the vermiform appendix. Laparoscopy is the standard surgical approach. This study aimed to outline the epidemiological, clinical, therapeutic, and outcome characteristics of patients undergoing laparoscopic surgery for acute appendicitis. Patients and Methods: A descriptive, retrospective analysis was carried out in the Emergency and Digestive Surgery departments of the University Hospital Center of Brazzaville, spanning two years from January 1, 2021, to December 31, 2022. The study included all patients who underwent laparoscopic surgery for non-complicated acute appendicitis. Results: The study included 12 cases of non-complicated acute appendicitis treated with urgent laparoscopy. The mean age of the patients was 37 ± 8.9 years, with a sex ratio of 0.7. The predominant symptom leading to consultation was pain in the right iliac fossa, with an average time to consultation of 6.4 ± 5.7 hours. Patient histories included diabetes in one case, obesity in two cases, and one case of prior abdominoplasty. During surgery, a phlegmonous appendix was observed in nine patients. The average duration of hospital stay was 3.6 ± 1.3 days, with all patients experiencing uncomplicated recoveries. Conclusion: The practice of emergency laparoscopic appendectomy is still relatively infrequent in our setting and presents an ongoing challenge.展开更多
AIM: To compare the outcome of laparoscopic versus open appendectomy. METHODS: Prospectively collected data from 293 consecutive patients with acute appendicitis were studied. These comprised of 165 patients who under...AIM: To compare the outcome of laparoscopic versus open appendectomy. METHODS: Prospectively collected data from 293 consecutive patients with acute appendicitis were studied. These comprised of 165 patients who underwent conventional appendectomy and 128 patients treated laparoscopically. The two groups were compared with respect to operative time, length of hospital stay, postoperative pain, complication rate and cost. RESULTS: There were no statistical differences regarding patient characteristics between the two groups. Conversion to laparotomy was necessary in 2 patients (1.5%). Laparoscopic appendectomy was associated with a shorter hospital stay (2.2 d vs 3.1 d, P = 0.04), and lower incidence of wound infection (5.3% vs 12.8%, P = 0.03). However, in patients with complicated disease, intra-abdominal abscess formation was more common after laparoscopic appendectomy (5.3% vs 2.1%, P = 0.002). The operative time and analgesia requirements were similar in the two groups. The cost of treatment was higher by 370 € in the laparoscopic group. CONCLUSION: Laparoscopic appendectomy is as safe and effi cient as open appendectomy, provided surgical experience and equipment are available.展开更多
Foreign bodies are rare causes of appendicitis and,in most cases,ingested foreign bodies pass through the alimentary tract asymptomatically.However,ingested foreign bodies may sometimes remain silent within the append...Foreign bodies are rare causes of appendicitis and,in most cases,ingested foreign bodies pass through the alimentary tract asymptomatically.However,ingested foreign bodies may sometimes remain silent within the appendix for many years without an inflammatory response.Despite the fact that cases of foreign-bodyinduced appendicitis have been documented,sharp and pointed objects are more likely to cause perforations and abscesses,and present more rapidly after ingestion.Various materials,such as needles and drill bits,as well as organic matter,such as seeds,have been implicated as causes of acute appendicitis.Clinical presentation can vary from hours to years.Blunt foreign bodies are more likely to remain dormant for longer periods and cause appendicitis through obstruction of the appendiceal lumen.We herein describe a patient presenting with a foreign body in his appendix which had been swallowed 15 years previously.The contrast between the large size of the foreign body,the long clinical history without symptoms and the total absence of any histological inflammation was notable.We suggest that an elective laparoscopic appendectomy should be offered to such patients as a possible management option.展开更多
目的探讨腹腔镜阑尾切除术(LA)与开腹阑尾切除术(OA)在小儿复杂肝下阑尾炎中的诊疗效果。方法选取我院2013年1月—2020年2月收治的40例肝下阑尾炎患儿为研究对象,依据手术方式的不同分为LA组(n=22)和OA组(n=18),比较两组患儿发病及手术...目的探讨腹腔镜阑尾切除术(LA)与开腹阑尾切除术(OA)在小儿复杂肝下阑尾炎中的诊疗效果。方法选取我院2013年1月—2020年2月收治的40例肝下阑尾炎患儿为研究对象,依据手术方式的不同分为LA组(n=22)和OA组(n=18),比较两组患儿发病及手术时间、术中出血量、术后切口感染、腹腔残余感染及肠梗阻、术后24 h C-反应蛋白(CRP)、术后排气时间、住院时间及住院费用等情况。结果LA组19例在腹腔镜下完成手术,3例中转开腹;两组在术中出血量、术后24 h CRP、术后排气时间、住院费用方面比较,差异有统计学意义(P<0.05);而在手术时间、术后并发症及住院时间等方面比较无统计学差异(P>0.05);术前未确诊病例:LA组/OA组6/4(P>0.05),但有临床意义。结论腹腔镜手术诊治小儿复杂肝下阑尾炎是一种安全可行有效的微创方式,具有创伤小、出血少、并发症少,恢复快、经济实用等优势,值得在小儿腹部外科疑难复杂疾病的诊断和适应症明确的手术中广泛应用。展开更多
基金Supported by Natural Science Foundation of Liaoning Province,No.2023-MS-354Science and Technology Project for Youth of Chaoyang Central Hospital,China Medical University.
文摘BACKGROUND Because of the mild inflammatory status in acute uncomplicated appendicitis,our team developed a novel technical protocol for single-port laparoscopic appendec-tomy using needle-type grasping forceps(SLAN)and achieved positive clinical outcomes.However,the intraoperative procedure lacked stability and fluency due to a series of problems highlighted by the small incision design of the proto-col(only 1 cm long).Therefore,there is a growing clinical demand to further opti-mize the SLAN protocol.CASE SUMMARY An adult male patient was admitted for persistent right lower abdominal pain with preoperative computed tomography findings suggestive of appendicitis accompanied by localized peritonitis.A modified technical protocol for SLAN based on minimally invasive surgical principles was used,and the patient was confirmed to have acute simple appendicitis by postoperative pathological ana-lysis.Postoperative recovery was uneventful,and no postoperative complications,such as incision infection or severe incision pain,were observed.The patient was discharged successfully on postoperative day 2.CONCLUSION The modified technical protocol of SLAN may be a new minimally invasive surgical alternative for patients with acute simple appendicitis.
文摘Introduction: Acute appendicitis represents an urgent surgical condition, requiring the removal of the vermiform appendix. Laparoscopy is the standard surgical approach. This study aimed to outline the epidemiological, clinical, therapeutic, and outcome characteristics of patients undergoing laparoscopic surgery for acute appendicitis. Patients and Methods: A descriptive, retrospective analysis was carried out in the Emergency and Digestive Surgery departments of the University Hospital Center of Brazzaville, spanning two years from January 1, 2021, to December 31, 2022. The study included all patients who underwent laparoscopic surgery for non-complicated acute appendicitis. Results: The study included 12 cases of non-complicated acute appendicitis treated with urgent laparoscopy. The mean age of the patients was 37 ± 8.9 years, with a sex ratio of 0.7. The predominant symptom leading to consultation was pain in the right iliac fossa, with an average time to consultation of 6.4 ± 5.7 hours. Patient histories included diabetes in one case, obesity in two cases, and one case of prior abdominoplasty. During surgery, a phlegmonous appendix was observed in nine patients. The average duration of hospital stay was 3.6 ± 1.3 days, with all patients experiencing uncomplicated recoveries. Conclusion: The practice of emergency laparoscopic appendectomy is still relatively infrequent in our setting and presents an ongoing challenge.
文摘AIM: To compare the outcome of laparoscopic versus open appendectomy. METHODS: Prospectively collected data from 293 consecutive patients with acute appendicitis were studied. These comprised of 165 patients who underwent conventional appendectomy and 128 patients treated laparoscopically. The two groups were compared with respect to operative time, length of hospital stay, postoperative pain, complication rate and cost. RESULTS: There were no statistical differences regarding patient characteristics between the two groups. Conversion to laparotomy was necessary in 2 patients (1.5%). Laparoscopic appendectomy was associated with a shorter hospital stay (2.2 d vs 3.1 d, P = 0.04), and lower incidence of wound infection (5.3% vs 12.8%, P = 0.03). However, in patients with complicated disease, intra-abdominal abscess formation was more common after laparoscopic appendectomy (5.3% vs 2.1%, P = 0.002). The operative time and analgesia requirements were similar in the two groups. The cost of treatment was higher by 370 € in the laparoscopic group. CONCLUSION: Laparoscopic appendectomy is as safe and effi cient as open appendectomy, provided surgical experience and equipment are available.
文摘Foreign bodies are rare causes of appendicitis and,in most cases,ingested foreign bodies pass through the alimentary tract asymptomatically.However,ingested foreign bodies may sometimes remain silent within the appendix for many years without an inflammatory response.Despite the fact that cases of foreign-bodyinduced appendicitis have been documented,sharp and pointed objects are more likely to cause perforations and abscesses,and present more rapidly after ingestion.Various materials,such as needles and drill bits,as well as organic matter,such as seeds,have been implicated as causes of acute appendicitis.Clinical presentation can vary from hours to years.Blunt foreign bodies are more likely to remain dormant for longer periods and cause appendicitis through obstruction of the appendiceal lumen.We herein describe a patient presenting with a foreign body in his appendix which had been swallowed 15 years previously.The contrast between the large size of the foreign body,the long clinical history without symptoms and the total absence of any histological inflammation was notable.We suggest that an elective laparoscopic appendectomy should be offered to such patients as a possible management option.
文摘目的探讨腹腔镜阑尾切除术(LA)与开腹阑尾切除术(OA)在小儿复杂肝下阑尾炎中的诊疗效果。方法选取我院2013年1月—2020年2月收治的40例肝下阑尾炎患儿为研究对象,依据手术方式的不同分为LA组(n=22)和OA组(n=18),比较两组患儿发病及手术时间、术中出血量、术后切口感染、腹腔残余感染及肠梗阻、术后24 h C-反应蛋白(CRP)、术后排气时间、住院时间及住院费用等情况。结果LA组19例在腹腔镜下完成手术,3例中转开腹;两组在术中出血量、术后24 h CRP、术后排气时间、住院费用方面比较,差异有统计学意义(P<0.05);而在手术时间、术后并发症及住院时间等方面比较无统计学差异(P>0.05);术前未确诊病例:LA组/OA组6/4(P>0.05),但有临床意义。结论腹腔镜手术诊治小儿复杂肝下阑尾炎是一种安全可行有效的微创方式,具有创伤小、出血少、并发症少,恢复快、经济实用等优势,值得在小儿腹部外科疑难复杂疾病的诊断和适应症明确的手术中广泛应用。
