Shen Yang,Zhuo Baobiao,Sun Qingzeng.Efficacy of laparoscopic-assisted appendectomy versus laparotomy of pediatric appendicitis with different pathological types[J].Journal of Clinical Pediatric Surgery,,18():784-788.[doi:10.3969/j.issn.1671-6353.2019.09.016]
Efficacy of laparoscopic-assisted appendectomy versus laparotomy of pediatric appendicitis with different pathological types
- Keywords:
- Laparoscopes; Appendicitis; Child
- CLC:
- R726.1;R574.61
- Abstract:
- Objective To explore the efficacy of laparoscopic-assisted appendectomy versus laparotomy of pediatric appendicitis with different pathological types.Methods Retrospective analysis was performed for 362 hospitalized appendicitis children from January in 2009 to December in 2013.They were confirmed by postoperative pathology as simple appendicitis(n=92),suppurative appendicitis(n=184)and gangrenous appendicitis(n=86).They underwent laparoscopic-assisted appendectomy(LA)and open appendectomy(OA)under emergency.Postoperative complications of laparoscopic-assisted appendectomy were evaluated in children with different pathological types.Results In simple appendicitis group,intestinal obstruction(n=2,4.3% vs. n=9,19.6%)(P=0.04)and incision infection(n=1,2.2% vs. n=8,17.4%)(P=0.024); in suppurative appendicitis group:intestinal obstruction(n=5,6.0% vs. n=14,14%)(P=0.074)and incision infection(n=5,6.0% vs. n=12,12%)(P=0.158); in gangrene appendicitis group:intestinal obstruction(n=3,6% vs. n=4,8.7%)(P=0.649); incision infection(n=5,10% vs. n=12,12%)(P=0.119).Conclusion As compared with OA,the efficacy of LA appendectomy is better for simple appendectomy.Significant differences exist in the incidence of intestinal obstruction and wound infection between LA and OA(P<0.05).Laparoscopy is not superior to simple appendicitis.No significant difference exists in the incidence of intestinal obstruction or incision infection between LA and OA in suppurative or gangrenous appendicitis(P>0.05).For non-simple appendicitis,laparoscopic appendectomy offers no advantage.Pediatric appendicitis should be diagnosed and resected laparoscopically as early as possible.
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Memo
收稿日期:2018-10-25。
基金项目:江苏省青年医学重点人才，江苏省卫生计生委项目（编号：QNRC2016373）
通讯作者:禚保彪,Email:zhuobaobiao@163.com