[1]赵威威 陈宇罡 张克玲 李久澄 米泰宇.腹腔镜手术治疗复杂性阑尾炎[J].中国微创外科杂志,2013,13(7):636-644.
 Zhao Weiwei,Chen Yugang,Zhang Keling,et al.Laparoscopic Appendectomy for Complicated Appendicitis: A Report of 87 Cases[J].Chinese Journal of Minimally Invasive Surgery,2013,13(7):636-644.
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腹腔镜手术治疗复杂性阑尾炎()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
13
期数:
2013年7期
页码:
636-644
栏目:
出版日期:
2013-07-20

文章信息/Info

Title:
Laparoscopic Appendectomy for Complicated Appendicitis: A Report of 87 Cases
作者:
赵威威 陈宇罡 张克玲 李久澄 米泰宇
甘肃省兰州市第二人民医院普外三科,兰州730046
Author(s):
Zhao Weiwei Chen Yugang Zhang Keling et al.
Department of General Surgery, The Second People's Hospital of Lanzhou, Lanzhou 730046, China
关键词:
复杂性阑尾炎腹腔镜阑尾切除术
Keywords:
Complicated appendicitisLaparoscopy appendectomy
分类号:
R656.8
文献标志码:
A
摘要:
目的总结腹腔镜手术治疗复杂性阑尾炎的经验。方法2008年2月~2012年2月对87例复杂性阑尾炎(坏疽、穿孔性阑尾炎或阑尾周围脓肿形成)行腹腔镜手术,术式包括腹腔镜阑尾切除联合腹腔冲洗引流,腹腔镜下阑尾脓肿清创引流术。结果无死亡病例,3例中转开腹,4例阑尾周围脓肿形成需要行二期阑尾切除术。手术时间(54±21)min,术后肛门排气时间(38±13)h,术后住院时间(5.0±1.4)d。术后6例出现并发症,其中戳孔感染3例,切口换药后愈合;腹腔残余脓肿2例,抗炎治疗后脓肿逐渐吸收;粪漏1例,经过肠外营养支持、充分引流及使用抗生素后愈合。80例随访8~44个月,平均14个月,2例出现粘连性肠梗阻,余无其他并发症出现。结论腹腔镜手术治疗复杂性阑尾炎是安全有效的。
Abstract:
ObjectiveTo summarize our experiences of laparoscopic appendectomy for complicated appendicitis.Methods Between February 2008 and February 2012, we performed laparoscopic appendectomy on 87 cases of complicated appendicitis, which were identified as gangrenous, perforated appendicitis and periappendiceal abscess. The procedure included laparoscopic appendectomy combined with peritoneal irrigation, laparoscopic debridement and drainage of periappendiceal abscess.ResultsAll the operations were successful without any perioperative deaths. 3 patients were converted to laparotomy and 4 patients with periappendiceal abscess needed a twostage appendectomy. The operation time was (54±21) min, the time of anal exsufflation was (38±13)h, and the postoperative hospital stay was (5.0±1.4) d. Postoperative complications occurred in 6 cases, including 3 cases of portsite infection and 2 cases of residual intraabdominal abscesses. All the 5 cases recovered after treatment. One patient experienced a fecal fistula postoperatively and healed with conservative treatment. Eighty patients were followed up for 8 to 44 months, with an average of 14 months. Adhesive ileus occurred in 2 patients and no other complications were found.ConclusionLaparoscopic surgery is safe and effective in treating complicated appendicitis.

参考文献/References:

[1]Heinzelmann M, Simmen HP, Cummins AS, et al. Is laparoscopic appendectomy the new “gold standard”?Arch Surg,1995,130:782-785.
[2]Katkhouda N,Mason RJ,Towfigh S,et al. Laparoscopic versus open appendectomy:a prospective randomized doubleblind study. Ann Surg,2005,242:439-450.
[3]Cueto J, D’Allemagne B, VazquezFrias JA, et al. Morbidity of laparoscopic surgery for complicated appendicitis: an international study. Surg Endosc,2006,20:717-720.
[4]王育和,刘家峰,徐大华,等.腹腔镜与开腹阑尾切除术治疗穿孔性阑尾炎的比较.中国微创外科杂志,2007,7(12):1184-1185.
[5]Laparoscopic appendectomy for complicated acute appendicitis does not result in increased surgical complications. Asian J Surg,2012,35(3):113-116.
[6]Garg CP, Vaidya BB, Chengalath MM. Efficacy of laparoscopy in complicated appendicitis. Int J Surg,2009,7:250-252.
[7]余俊英,冯泽荣,黄顺荣,等.46例困难的腹腔镜阑尾切除术分析.中国微创外科杂志,2009,9(5):474-475.
[8]李健,马骏.腹腔镜下原位逆行切除阑尾在急性重型阑尾炎中的应用.中国微创外科杂志,2011,11(12):1136-1137.
[9]Gupta R, Sample C, Bamehriz F, et al. Infectious complications following laparoscopic appendectomy. Can J Surg,2006,49:397-400.

更新日期/Last Update: 2014-10-14