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首页> 外文期刊>Journal of Clinical Medicine Research >Lessons Learned With Laparoscopic Management of Complicated Grades of Acute Appendicitis
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Lessons Learned With Laparoscopic Management of Complicated Grades of Acute Appendicitis

机译：腹腔镜治疗复杂度急性阑尾炎的经验教训

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Background: Laparoscopy has not been consolidated as the approach of first choice in the management of complicated appendicitis. Methodological flaws and absence of disease stratification criteria have been implicated in that less evidence. The objective is to study the safe and effectiveness of laparoscopy in the management of complicated appendicitis according to laparoscopic grading system. Method: From January 2008 to January 2011, 154 consecutive patients who underwent a laparoscopic appendectomy for complicated appendicitis were evaluated in the prospective way. The patient’s age ranged from 12 to 75 years old (31.7 ± 13.3) and 58.3% were male. Complicated appendicitis refers to gangrenous and/or perforated appendix and were graded as 3A (segmental necrosis), 3B (base necrosis), 4A (abscess), 4B (regional peritonitis) and 5 (diffuse peritonitis). The outcomes including operative time, infection complication, operative complications and conversion rate were chosen to evaluate the procedure. Results: The grade 3A was the most frequent with 50 (32.4%) patients. The mean operative time was 69.4 ± 26.3 minutes. The grade 4A showed the highest mean operative time (80.1 ± 26.7 minutes). The wound and intra-abdominal infection rates were 2.6 and 4.6%, respectively. The base necrosis was the most important factor associated with the conversion (5.2%). The grades 4A and 5 were associated with greater possibility of intra-abdominal collection. There were no operative complications. Conclusion: The laparoscopic management of all complicated grades of acute appendicitis is safe and effective and should be the procedure of first choice. The laparoscopic grading system allows us to assess patients in the same disease stage.J Clin Med Res. 2014;6(4):261-266doi: http://dx.doi.org/10.14740/jocmr1837w
机译：背景：腹腔镜检查尚未作为复杂性阑尾炎的首选治疗方法得到巩固。在较少的证据中暗示了方法学上的缺陷和疾病分层标准的缺失。目的是根据腹腔镜分级系统研究腹腔镜在处理复杂性阑尾炎中的安全性和有效性。方法：从2008年1月至2011年1月，以前瞻性方式评估了154例因复杂性阑尾炎而接受腹腔镜阑尾切除术的患者。患者的年龄在12至75岁之间（31.7±13.3），男性占58.3％。复杂性阑尾炎是指坏疽性和/或穿孔性阑尾，分为3A（节段性坏死），3B（基础坏死），4A（脓肿），4B（区域性腹膜炎）和5（弥漫性腹膜炎）。选择包括手术时间，感染并发症，手术并发症和转化率在内的结果来评估手术过程。结果：3A级患者最常见，有50名患者（32.4％）。平均手术时间为69.4±26.3分钟。 4A级显示最高平均手术时间（80.1±26.7分钟）。伤口和腹腔内感染率分别为2.6％和4.6％。基础坏死是与转化相关的最重要因素（5.2％）。 4A级和5级与腹腔内收集的可能性更大有关。没有手术并发症。结论：腹腔镜手术治疗所有复杂等级的急性阑尾炎是安全有效的，应作为首选方法。腹腔镜分级系统使我们能够评估处于同一疾病阶段的患者。JClin Med Res。 2014; 6（4）：261-266doi：http://dx.doi.org/10.14740/jocmr1837w

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