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首页> 外文期刊>Surgical Endoscopy >Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis.
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Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis.

机译：腹腔镜，开放和转换阑尾切除术治疗穿孔性阑尾炎的比较。

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BACKGROUND: Perforated appendicitis is associated with a significant risk of postoperative abdominal and wound infection. Only a few controversial studies evaluate the role of laparoscopy in perforated appendicitis. The significance of conversion from laparoscopy to open appendectomy for perforated appendicitis is not well defined. Statistical analysis was performed using Student's t-test. METHODS: Data on 52 patients with perforated appendicitis were prospectively collected and retrospectively reviewed. Among these patients, 18 had laparoscopic appendectomies (LA); 24 had open appendectomies (OA); and 10 had converted appendectomies (CA). The indications for either method were based on the attending surgeons's philosophy. Laparoscopic appendectomy was performed using a retrograde stapler technique. Operative time, hospital stay, ability to tolerate a liquid diet, and postoperative infectious complications were documented. RESULTS: No statistically significant difference in the operative time in minutes was found between the LA (114 +/- 29.3), CA (120.0 +/- 32.2), and OA (105.8 +/- 64.1) groups (p = NS). There was no statistically significance difference in length of stay (days) between the LA (9.2 +/- 4.1), OA (10.5 +/- 3.3), and CA (10.0 +/- 1.8) groups. The wound infection rate was less frequent in the LA group (0%) than in 0A (14%) and CA (10%) groups. The rate of intra-abdominal abscess infections (IAAs) and ileus were 22% and 28%, respectively, in LA group, 38% and 29%, respectively, in OA group, and 60% and 50%, respectively, in CA group. CONCLUSIONS: No difference in the rate of postoperative intra-abdominal abscesses exists between laparoscopic and open appendectomy for perforated appendicitis. Wound infections and ileus complicate the postoperative course of patients after laparoscopic appendectomy less frequently than after open appendectomy. The conversion of laparoscopic to open appendectomy for perforated appendicitis is associated with increased postoperative morbidity.
机译：背景：穿孔的阑尾炎与术后腹部和伤口感染的重大风险有关。只有少数有争议的研究评估腹腔镜在穿孔阑尾炎中的作用。对于腹膜穿孔炎，从腹腔镜手术转换为开放式阑尾切除术的意义尚不明确。使用学生t检验进行统计分析。方法：前瞻性收集和回顾性分析52例穿孔性阑尾炎患者的数据。在这些患者中，有18例患有腹腔镜阑尾切除术（LA）; 24例患有开放性阑尾切除术（OA）;和10位已完成阑尾切除术（CA）。两种方法的适应症均基于主治医师的理念。腹腔镜阑尾切除术采用逆行缝合技术进行。记录手术时间，住院时间，耐受流质饮食的能力以及术后感染并发症。结果：LA（114 +/- 29.3），CA（120.0 +/- 32.2）和OA（105.8 +/- 64.1）组之间的分钟手术时间差异无统计学意义（p = NS）。 LA（9.2 +/- 4.1），OA（10.5 +/- 3.3）和CA（10.0 +/- 1.8）组之间的住院天数（天数）没有统计学显着性差异。 LA组（0％）的伤口感染率低于0A（14％）和CA（10％）组。腹腔内脓肿（IAA）和肠梗阻的发生率在LA组分别为22％和28％，在OA组分别为38％和29％，在CA组分别为60％和50％ 。结论：腹腔镜和开放式阑尾切除术治疗穿孔性阑尾炎的术后腹腔内脓肿发生率没有差异。伤口感染和肠梗阻使腹腔镜阑尾切除术后患者的病程复杂化的频率低于开放阑尾切除术后。对于穿孔的阑尾炎，腹腔镜向开放性阑尾切除术的转换与术后发病率增加相关。

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