单孔腹腔镜阑尾切除术的常见困难与处理
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陈生, Email: chensheng99@163.com

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广东省医学科研资助项目(A2011621)。


Common difficulties and solutions in transumbilical single-port laparoscopic appendectomy
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    摘要:

    目的:探讨经脐单孔腹腔镜行阑尾切除的手术中的常见困难与处理方法。 方法:回顾性分析勒流医院2009年6月—2012年2月采取经脐单孔腹腔镜治疗的86例阑尾炎患者的临床资料。 结果:处理困难包括腹腔脓液积聚15例,阑尾显露困难6例,残端处理困难5例,腹腔粘连3例;78例在单孔腹腔镜下完成手术,8例转为常规腹腔镜手术,无中转开腹者;手术时间(41.39±13.76)min,住院时间(4.82±2.16)d;全组无术后出血、切口感染等并发症。 结论:单孔腹腔镜行阑尾切除手术是安全可行的;阑尾切除困难时,应视阑尾病变的情况采取相应的方法和技巧,能有效的防止并发症的发生。

    Abstract:

    Objective: To investigate the common difficulties and solutions in transumbilical single-port laparoscopic appendectomy. Methods: The clinical data of 86 patients with appendicitis undergoing transumbilical single-port laparoscopic treatment in Leliu Hospital from June 2009 to February 2012 were retrospectively analyzed. Results: The difficulties encountered during operation included 15 cases of intra-abdominal abscess, 6 cases with difficulties in appendix exposure, 5 cases with difficulties in appendiceal stump treatment and 3 cases of abdominal adhesions. Single-port laparoscopic appendectomy was successfully performed in 78 cases, 8 cases were converted to conventional laparoscopic operation and there was no open conversion. The average operative time was (41.39±13.76) min and the length of postoperative hospital stay was (4.82±2.16) d. No complications such as postoperative hemorrhage and wound infection occurred in any of the patients. Conclusion: Transumbilical single-port laparoscopic appendectomy is safe and feasible. The appropriate methods and techniques should be taken according to the appendiceal lesions when it is difficult to perform single-port laparoscopic appendectomy, so as to effectively prevent complications.

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陈生|向军2|谢春文|黎淑君|麦碧茹|.单孔腹腔镜阑尾切除术的常见困难与处理[J].中国普通外科杂志,2012,21(8):989-991.
DOI:10.7659/j. issn.1005-6947.2012.08.019

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  • 收稿日期:2012-05-03
  • 最后修改日期:2012-07-20
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  • 在线发布日期: 2012-08-15