经脐单孔腹腔镜阑尾切除术在年长儿中的应用探索

摘要

Objective To investigate the feasibility and treatment experience of umbilical single port laparoscopic appendectomy (USPLA) on acute appendicitis.Methods 68 patients with acute appendicitis were selected from January 2012 to January 2016, and were used USPLA. The median sagittal incision was made in umbilical nest, did not exceed the scope of the umbilical fossa. The 0.5 cm trocar was seted lower pole, closed to the trocar clipping aponeurosis, operating equipment was seted upper incision pole. The appendix was identiifed and exter iorized through the umbilical cannula. Appendectomy was performed using the traditional method, but outside the abdominal cavity. Results The mean operating time was 12~ 65 min. All the incisions were healed at the ifrst intention. No recent postoperative complication occurred. The incisional scar was not occurred at abdomen.ConclusionUSPLA is safe and feasible technique for the treatment of older children with acute appendicitis. Cosmetically, it is more superior to the open surgery.%目的探讨经脐单孔腹腔镜阑尾切除术治疗年长儿急性阑尾炎的可行性及治疗经验。方法选取我院2012年1月~2016年1月收治的年长儿急性阑尾炎68例，均选择经脐单孔腹腔镜阑尾切除术，脐窝正中矢状切口，不超出脐窝范围，下极置0.5 cm戳卡，紧贴戳卡夹闭腱膜，切口上极置操作器械；腹腔镜下找到阑尾，夹住阑尾尖端，将阑尾完整地从脐部拖出腹腔外，用常规开腹阑尾切除的方法处理阑尾及其系膜，完成阑尾切除术。结果本组手术时间12～65 min，术后切口全部一期愈合，无近期并发症。腹部未见切口瘢痕。结论脐部单孔法腹腔镜阑尾切除术是年长儿阑尾炎治疗中简洁、有效的手术方法之一，并使部分阑尾炎手术成为一种美容手术。