Ma Puneng,Bai Qiang,Li Yadong,et al.Clinical application of two-hole umbilical laparoscopy for non-complex appendicitis[J].Journal of Clinical Pediatric Surgery,2021,20(09):857-860.[doi:10.12260/lcxewkzz.2021.09.011]
脐部两孔法腹腔镜手术治疗非复杂性阑尾炎的临床研究
- Title:
- Clinical application of two-hole umbilical laparoscopy for non-complex appendicitis
- Keywords:
- Appendicitis/SU; Appendicitis/CO; Laparoscopy; Treatment Outcome
- 分类号:
- R656.8;R726.1
- 摘要:
- 目的 探讨经脐部两孔法行腹腔镜阑尾切除术治疗非复杂型阑尾炎的可行性及临床应用价值。方法 2018年8月至2019年7月，对昆明市儿童医院收治的盲肠前位、非浆膜下、未穿孔的47例非复杂型阑尾炎患者尝试仅取脐下缘一个操作孔，同时于右下腹缝入2-0带针慕丝线悬吊阑尾的方法进行腹腔镜阑尾切除术。收集术中能否顺利切除阑尾、有无中转开腹、有无手术副损伤、手术时间、术中出血量、住院天数及术后腹部美观情况。结果 47例手术均获成功，术中未增加操作孔，无一例中转开腹，术中无肠管、血管、输尿管等组织损伤；手术时间（48.6±7.5）min；术中出血量（5.9±2.5）mL。无一例手术切口感染，出院时血液分析及腹腔B超检查均无异常，住院天数（4.2±0.7）d；手术切口仅局限于脐部，且切口直径<1 cm，伤口外观视觉效果良好。结论 对于盲肠前位、非浆膜下且未穿孔的非复杂型阑尾炎，采用脐部两孔法行腹腔镜阑尾切除术安全、有效，临床可行，创伤小、伤口外观美观，具有良好的临床应用价值。
- Abstract:
- Objective To explore the clinical feasibility and application value of two-hole umbilical laparoscopy for non-complex appendicitis.Methods From August 2018 to July 2019, 47 children were diagnosed as non-complex appendicitis.The laparoscopic locations of appendix were anterior cecum, non-subserosal and non-perforated.Only one operative hole was created at the lower margin of umbilicus and sew 2-0 mousse thread guided with a needle into right lower abdomen for overhanging appendix simultaneously.Whether or not appendix could be removed successfully, conversion into open operation, intraoperative injury, operative duration and intraoperative volume of blood loss were adopted as the evaluation criteria of feasibility.And hospitalization stay and postoperative abdominal aesthetics were selected as the evaluation criteria of clinical value.Results All operations were successful.No operative hole was added and there was no conversion into laparotomy.Operation duration was (48.6±7.5) min and intraoperative volume of blood loss (5.9±2.5) ml.There was no injury of intestine, blood vessel, ureter or other tissues.None of them developed surgical infection.Blood analysis and abdominal ultrasound showed no abnormalities at discharge.The hospital stay was (4.2±0.7) days.The surgical incision <1 cm was only limited to umbilicus.Conclusion For non-complex appendicitis, two-hole laparoscopic appendectomy through umbilicus is safe, feasible and efficacious.Compared with other surgical approaches, such a method is mini-invasive and more aesthetic.Wider clinical applications are worthwhile.
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备注/Memo
收稿日期:2019-10-30。
基金项目:云南省卫生科技计划资助项目（编号：2017NS110）
通讯作者:白强,Email:576967639@qq.com