摘要
目的评价免气腹单孔腹腔镜阑尾切除术的可行性和效果。方法 2008年8月～2009年10月,对69例急性阑尾炎行免气腹单孔腹腔镜阑尾切除术。在硬膜外麻醉下,在右下腹麦氏点处做1.5～1.8 cm的切口,用免气腹悬吊装置,提起右下腹壁,建立腹腔镜操作空间。阑尾切除的方法有以下3种:完全腹腔外切除阑尾;腹腔内先游离阑尾,然后再在腹腔外切除阑尾;在腹腔内完成阑尾切除术所有的操作。如果有局限性腹膜炎,或阑尾残端炎症严重或残端处理不满意,则在右下腹放置引流管,并从切口处引出。结果 3例需要延长切口完成手术。免气腹单孔腹腔镜阑尾切除术成功66例,平均手术时间51 min(38～72 min),术中出血<10 ml,无邻近肠管损伤。手术后24 h内均能下床活动。术后1例局限腹腔感染,1例切口感染,无腹腔出血。2例均经保守治疗痊愈。结论免气腹单孔腹腔镜阑尾切除术是一种安全可行的方法。
Objective To evaluate the feasibility and efficacy of gasless single-trocar laparoscopic appendectomy.Methods From August 2008 to October 2009,69 patients with acute appendicitis underwent gasless single-trocar laparoscopy in our hospital.Under epidural anesthesia,a 1.5-to 1.8-cm incision was made at the McBurney point,and then an abdominal wall lifting device was employed in the right lower quadrant to establish an operating space.Appendectomy was accomplished extracorporeally,extracorporeally and then intracorporeally,or intracorporeally.Abdominal drainage was then carried out in case of localized peritonitis or severe inflammation of the appendiceal stump. Results The procedure was competed successfully in 66 cases,while the other three received extension of the incision.The mean operation time was 51 min（ranged from 38 to 72 min）,during which the blood loss was less than 10 ml.All the patients resumed their mobility in 24 hours after the operation.One patient developed localized intraabdominal infection and one patient showed incisional infection after the operation.Both the cases were cured by conservative therapy.Conclusions Gasless single-trocar laparoscopic appendectomy is feasible and safe for acute appendicitis.
出处
《中国微创外科杂志》
CSCD
2010年第11期981-983,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
免气腹
单孔腹腔镜
急性阑尾炎
硬膜外麻醉
Gasless
Single-trocar laparoscopy
Acute appendicitis
Epidural anesthesia
