改良荷包缝合法在腹腔镜阑尾切除术中的应用

发布时间：2018-07-18 11:49

【摘要】：目的探讨改良荷包缝合法在腹腔镜阑尾切除术中的可行性及临床效果。方法 2012年1月~2014年12月我科在36例腹腔镜阑尾切除术中应用改良荷包缝合法,即间断环形缝合前半荷包与间断纵形(或斜形)缝合后半荷包合成一个荷包,包埋阑尾残端。结果术中无须改变持针方式和缝合习惯即可轻松完成腹腔镜下荷包缝合,36例LA均顺利收紧荷包缝线并包埋阑尾残端,无一例中转开腹。手术时间(70±20)min,术后住院时间(5±2)d。无荷包缝线撕裂浆肌层、阑尾残端漏或腹腔残余脓肿等并发症。36例术后半年通过电话随访,均无腹痛、腹胀等。结论改良荷包缝合法缝合荷包包埋阑尾残端具有操作方便,安全可靠的优点,避免应用传统方法缝合荷包给手术操作带来的诸多不便,降低因阑尾根部处理不满意而中转开腹的几率,值得推广应用。
[Abstract]:Objective to investigate the feasibility and clinical effect of modified purse suture in laparoscopic appendectomy. Methods from January 2012 to December 2014, the modified purse suture method was used in 36 cases of laparoscopic appendectomy, that is, the first half purse of discontinuous annular suture was combined with the longitudinal (or oblique) suture of the discontinuous shape, and the half purse was composed of one purse, which was used to bury the appendiceal stump. Results Laparoscopic purse suture was performed easily in 36 cases of LA without changing the needle holding and suture habits. All the 36 cases of LA successfully tightened the suture of the purse and buried the stump of the appendix. No case was transferred to open the abdomen. The operative time was (70 卤20) min and the postoperative hospitalization time was (5 卤2) d. No laceration of the sarcoplasmic muscle layer, leakage of appendicitis stump or abscess of abdominal cavity. 36 cases were followed up by telephone half a year after operation. There was no abdominal pain or abdominal distension. Conclusion the modified purse suture method has the advantages of convenient operation, safe and reliable operation, and avoids the inconvenience caused by the traditional method. It is worth popularizing to reduce the probability of conversion to laparotomy due to unsatisfactory management of appendix root.
【作者单位】：云南省红河州弥勒市人民医院普通外科;
【分类号】：R656.8

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