腹腔镜治疗阑尾周围脓肿临床探讨.pdf

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1、中华腔镜外科杂志(电子版)2008年6月第1卷第1期(试刊)Ch

2、nJLaparoscopicSurgery(ElectronicVersion)，June2008，Voll，No·137临床研究腹腔镜治疗阑尾周围脓肿临床探讨陆涛浦涧汪建初韦忠恒【摘要】目的探讨腹腔镜技术治疗阑尾周围脓肿的可行性和优势。方法选择性经腹腔镜治疗阑尾周围脓肿46例、开放阑尾周围脓肿手术54例以及保守治疗32例进行比较。结果腔镜组46例中35例进行～期腹腔镜阑尾切除术，l1例进行脓肿引流术，无中转开腹，无术后明显并发症。开放组54例中39例行一期阑尾切除，l5例行脓肿引流术，出现术后并发症9例。出院后2个

3、月再行阑尾切除术3例。保守治疗组32例，1例转手术治疗，2例治疗后复发手术治疗。结论经腹腔镜治疗阑尾周围脓肿是可行和安全的，并且降低治疗费用，减少住院天数，较传统开放及保守治疗明显缩短阑尾周围脓肿的病程。【关键词】阑尾周围脓肿；腹腔镜；开放手术；保守治疗IStherefeasibilityandadvantageinthetreatmentofgranulomaaroundtheappendixbylaparoscopy：Astudycomparativewiththeopenapproach&Conservativetreatmentin132patientsLUTao．PUJi

4、an,WANGJian—chu，eta1．Guangxi53300~China[Absract]ObjectiveThoughgranulomaaroundtheappendixisnotacontraindicationtolaparoscopicappendectomy(LA)，mostsurgeonshavenotembracedLAasthefirst—lineapproachtogranulomaaroundtheappendix．Infact，in2002，theCochraneDatabaseReviewconcluded：1)theclinicalefectsofL

5、Aare“smallandoflimitedclinicalrelevance，”and2)theadvantageofLAingranulomaaroundtheappendixrequiresfurtherstudy．Objective：TostudythefeasibilityandadvantageofLAversusopenappendectomy(OA)，Conservativetreatmentamongadultswithappendicitis．Methods132patientswereselectedintothestudy,theobservationpro

6、jectincludeoperationtime，hospitalstay,complications，whitebloodcellcount，bodytemperatureandtreatmentcostsetc．ResultsInthelaparoscopicgroup(46patients)，35patientswereperformedLAbyfirststep，11patientswereperformedlaparoscopicabscessdrainageonly,noonereversetoopenandhadnoobviouscomplications．Butin

7、theopengroup(54patients)，39performedOAbyfirststep，15patientswereperformedlaparoscopicabscessdrainageonly,3patientsoperatedagainafter2-month．Thereare9patientshaveconcurrency,includeswoundinfection，adhesiveintestinalobstructionandresidualabscess．Therearetwopatientsrecurrencedand1hadtobeoperatedb

8、ecausesymptomsdeterioratedintheconservativetreatmentgroup．ConclusionsTreatinggranulomaaroundtheappendixbylaparoscopyisfeasibleandmoreadvantageouscomparativet0theopenappendectomyandconservativetrcatment．[Keywords

9、Granulomaaroundtheappend