Tao Boyuan,Zeng Jixiao,Liu Fei,et al.Clinical comparison of intracorporeal versus extracorporeal approach of transumbilical single-port laparoscopic appendectomy with conventional laparoscopic instruments[J].Journal of Clinical Pediatric Surgery,,22():12-17.[doi:10.3760/cma.j.cn101785-202209019-003]
Clinical comparison of intracorporeal versus extracorporeal approach of transumbilical single-port laparoscopic appendectomy with conventional laparoscopic instruments
- Keywords:
- Laparoscopes; Appendectomy; Surgical Procedures; Operative; Child
- Abstract:
- ObjectiveTo compare the efficacies of intracorporeal versus extracorporeal approach of transumbilical single-port laparoscopic appendectomy (TUSPLA) and provide diversified options for acute appendicitis (AA) in children with conventional laparoscopic instruments. MethodsFrom January 2020 to January 2022,a total of 291 AA children were hospitalized and 280 of them underwent appendectomy.According to the inclusion criteria,clinical data were retrospectively reviewed for 113 children.Intracorporeal appendectomy (intra-group,n=48) and extracorporeal appendectomy (extra-group,n=65) were performed.Clinical baseline data,intraoperative findings and efficacies were compared between two groups. ResultsAll children underwent operations successfully.Age [(8.7±3.2) vs (7.8±1.8) years] and body mass index (BMI) [(18.1±1.6) vs (17.7±0.9) kg/m2] showed no significant inter-group difference (P>0.05); operative duration [(86.5±27.7) vs (50.2±22.6) min] was significantly different (P<0.05); blood loss [(6.7±3.2) vs (5.9±2.2) mL],postoperative exhaust time [(21.3±5.3) vs (20.1±3.6) h],postoperative hospital stay [(7.1±2.1) vs (6.7±1.3) day] and complication rate [10.5%(5/48) vs 10.8%(7/65)] showed no significant inter-group differences (P>0.05); In intra-group,5 cases developed complications,including abdominal abscess (n=2),incision infection (n=1),postoperative intestinal obstruction (n=1) and intestinal side injury (n=1); Seven cases became complicated in extra-group,including abdominal abscess (n=3),incision infection (n=2) and postoperative intestinal obstruction (n=2). ConclusionBoth types of TUSPLA with conventional laparoscopic instruments are safe and feasible with definite efficacies.No significant differences exist in complication rate,postoperative recovery time of intestinal function or postoperative hospital stay.However,extracorporeal approach is less difficult than intracorporeal approach and it may significantly shorten operative duration.
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Memo
收稿日期:2022-09-14。
基金项目:国家自然科学基金(82170528);广东省自然科学基金(2022A1515012254);广州市科技计划市校(院)联合资助项目(202201020612);广州市临床特色技术项目(2023C—TS48)
通讯作者:曾纪晓,Email:zengjixiao@163.com