经脐单孔腹腔镜阑尾切除术适应症的探讨
发布时间：2018-10-04 19:20
【摘要】：目的:通过比较应用经脐单孔腹腔镜(transumbilical laparoendoscopic single-site surgery,TU-LESS)与传统三孔腹腔镜(three—port Traditional laparoscopic)在化脓性阑尾炎手术中的疗效,来探讨TU-LESS技术在治疗化脓性阑尾炎伴腹膜炎体征患者时的适应症及功效。方法:选取2011年09月至2015年03月山西医科大学第一附属医院普通外科收治的化脓性阑尾炎伴穿孔或坏疽等并发症且继发腹膜炎体征的病例。其中应用TU-LESS技术进行腹腔探查后行阑尾切除术58例为实验组。另外,对照组选择相同的手术医生应用三孔腹腔镜施行阑尾切除术42例。比较两组的术中出血量、术后在院治疗时间、手术后肠功能恢复正常所需时间,手术所需时间、麻醉结束后疼痛程度等指标。结果:实验组与对照组相比,实验组应用TU-LESS技术完成手术52例,占实验组总手术量的89.65%,术中增加戳卡改为传统腹腔镜术式4例、术中改为传统剖腹阑尾切除术2例;对照组应用传统三孔法完成手术38例,占对照组总手术量的90.47%,术中更改为传统剖腹阑尾切除术4例.术中出血量、术后在院治疗时间、手术后肠功能恢复正常所需时间,手术所需时间均无统计学差异(P0.05)。传统腔镜组麻醉结束后疼痛感觉高于实验组(P0.05)。结论:在治疗伴腹膜炎体征的化脓性阑尾炎时TU-LESS技术可以满足术中所需的腹腔探查、阑尾切除的要求。经脐单孔腹腔镜阑尾切除术不仅可应用于单纯性阑尾炎,而且在伴腹膜炎体征的化脓性阑尾的诊断和治疗中也有确切的疗效。
[Abstract]:Objective: to compare the efficacy of transumbilical single-hole laparoscopic (transumbilical laparoendoscopic single-site surgery,TU-LESS) and traditional three-hole laparoscopy (three-port Traditional laparoscopic) in suppurative appendicitis. To investigate the indications and efficacy of TU-LESS technique in the treatment of suppurative appendicitis with peritonitis signs. Methods: cases of suppurative appendicitis with complications such as perforation or gangrene and secondary peritonitis signs were selected from the general surgery department of the first affiliated Hospital of Shanxi Medical University from September 2011 to March 2015. Among them, 58 cases were treated with appendectomy after abdominal exploration with TU-LESS technique. In addition, 42 cases of appendectomy were performed by three-hole laparoscopy in the control group. The blood loss during operation, the time of hospitalization after operation, the time required for the recovery of intestinal function after operation, the time required for operation, and the degree of pain after anesthesia were compared between the two groups. Results: compared with the control group, 52 patients in the experimental group were operated by TU-LESS technique, which accounted for 89.65% of the total operating volume in the experimental group, 4 cases were replaced by the traditional laparoscopic operation during the operation, and 2 cases were replaced by the traditional appendectomy during the operation. In the control group, 38 cases (90.47%) were operated by traditional three-hole method, and 4 cases were changed into traditional appendectomy during operation. There was no significant difference in the amount of blood lost during the operation, the time spent in hospital after operation, the time required for the recovery of intestinal function after operation, and the time required for operation (P0.05). The pain in the traditional endoscopic group was higher than that in the experimental group after anesthesia (P0.05). Conclusion: in the treatment of suppurative appendicitis with peritonitis signs, TU-LESS technique can meet the needs of abdominal exploration and appendectomy. Transumbilical laparoscopic appendectomy can not only be used in simple appendicitis, but also in the diagnosis and treatment of suppurative appendicitis with peritonitis signs.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R656.8
本文编号：2251565
[Abstract]:Objective: to compare the efficacy of transumbilical single-hole laparoscopic (transumbilical laparoendoscopic single-site surgery,TU-LESS) and traditional three-hole laparoscopy (three-port Traditional laparoscopic) in suppurative appendicitis. To investigate the indications and efficacy of TU-LESS technique in the treatment of suppurative appendicitis with peritonitis signs. Methods: cases of suppurative appendicitis with complications such as perforation or gangrene and secondary peritonitis signs were selected from the general surgery department of the first affiliated Hospital of Shanxi Medical University from September 2011 to March 2015. Among them, 58 cases were treated with appendectomy after abdominal exploration with TU-LESS technique. In addition, 42 cases of appendectomy were performed by three-hole laparoscopy in the control group. The blood loss during operation, the time of hospitalization after operation, the time required for the recovery of intestinal function after operation, the time required for operation, and the degree of pain after anesthesia were compared between the two groups. Results: compared with the control group, 52 patients in the experimental group were operated by TU-LESS technique, which accounted for 89.65% of the total operating volume in the experimental group, 4 cases were replaced by the traditional laparoscopic operation during the operation, and 2 cases were replaced by the traditional appendectomy during the operation. In the control group, 38 cases (90.47%) were operated by traditional three-hole method, and 4 cases were changed into traditional appendectomy during operation. There was no significant difference in the amount of blood lost during the operation, the time spent in hospital after operation, the time required for the recovery of intestinal function after operation, and the time required for operation (P0.05). The pain in the traditional endoscopic group was higher than that in the experimental group after anesthesia (P0.05). Conclusion: in the treatment of suppurative appendicitis with peritonitis signs, TU-LESS technique can meet the needs of abdominal exploration and appendectomy. Transumbilical laparoscopic appendectomy can not only be used in simple appendicitis, but also in the diagnosis and treatment of suppurative appendicitis with peritonitis signs.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R656.8
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相关期刊论文 前3条
1 朱江帆;徐曼珠;马颖璋;戴国清;胡海;;经脐入路腹腔镜胆囊切除术存在的问题与对策[J];肝胆胰外科杂志;2009年06期
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3 杜秉权;;腹腔镜三孔法胆囊阑尾切除术62例[J];中国中西医结合外科杂志;2009年05期
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