Objective To explore the clinical effect of laparoscopic clearance for peripheral abscess of appendix.Methods 83 patients with periappendicural abscess undergoing laparoscopic clearance in recent 6 years at our hospital were collected and were divided into three groups according to the diameter measured by CT:the diameter of group A was less than 5 cm,that of group C more than 7 cm,and that of group B 5-7 cm.The clinical effects of laparoscopic treatment for peripheral abscess of appendix with different sizes were analyzed and compared.Results The operation time was shortest [(57.63±14.51) min],the intra-operative bleeding volume was lowest [(7.64 ± 3.12) ml],no one took open surgery,the patients earliest took off-bed activity 24 h after operation,the anal exhaust time were shortest [(1.62 ± 0.52) d],the incision infection rate was lowest (5.9％),the primary healing rate was highest (94.1％),and the medical cost was lowest in group A.The operation time was longest [(81.73±13.15) min],33.3％ patients were transferred for open surgery,the time for off-bed activity after operation was longest,the incision infection rate was highest (33.3％),the incision non-primary healing rate within 7 d was highest,and the medical cost was highest in group C.There were no statistical differences in antalgic drug using rate and the incidences of other postoperative complications between these 3 groups (P ＞ 0.05).Conclusions Laparoscopic operation in the treatment of periappendiceal abscess whose diameter is less than 5.0 cm is reliable,mini-invasive and economic,so it is worth being generalized.Choosing Laparoscopic operation for periappendiceal abscess whose diameter is more than 7.0 cm should be cautious.%目的 探讨应用腹腔镜Ⅰ期切除阑尾脓肿的临床效果.方法 收集广州医科大学附属第五医院2010年4月至2016年3月收治可纳入研究的阑尾脓肿患者83例,均首选腹腔镜Ⅰ期切除阑尾脓肿,术前CT测量阑尾脓肿最大直径,分为A、B、C组,A组阑尾脓肿直径≤5 cm,B组5～7cm,C组≥7 cm.对比分析应用腹腔镜Ⅰ期切除阑尾脓肿的临床疗效.结果 A组手术时间最短[(57.63±14.51)min],术中出血量少[(7.64±3.12) ml],无中转开腹,术后24 h内下床活动早(82.4％),肛门排气时间早[(1.62±0.52)d],切口感染率小(5.9％),切口Ⅰ期愈合率高[32例(94.1％)],医疗花费少,与B组及C组比较,差异均有统计学意义(P＜0.05);C组手术时间最长[(81.73±13.15) rin],术中出血量[(19.21±3.73) ml]及中转开腹率(33.3％)明显增加,术后下床活动时间延长,切口感染率较高(33.3％),7d内切口非Ⅰ期愈合率增加,医疗花费明显升高;但3组患者在术后48 h内应用镇痛药的比例及其他术后并发症发生率比较,差异无统计学意义(P＞0.05).结论 腹腔镜Ⅰ期切除直径＜ 5cm的阑尾脓肿具有安全有效、愈合快、经济实用等优点,适合在临床普遍推广;临床选择腹腔镜Ⅰ期切除阑尾脓肿直径＞ 7cm的患者时需慎重.
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