单孔腹腔镜与常规腹腔镜阑尾切除术在儿童急性阑尾炎中的应用

摘要

Objetive To compare the efficacies of single -port laparoscopic appendectomy (SPLA) versus conventional tri -port laparoscopic appendectomy (TPLA). Methods Pediatric cases of acute appen-dicitis from January 2009 to December 2011 were reviewed retrospectively.To minimize the technical differ-ences among operators,all selected cases were operated by the same surgeon with extensive laparoscopic experi-ences.The comparative parameters included age,time between onset of abdominal pain to operation,operative duration,length of stay and pathological type.Results A total of 116 acute appendicitis patients were recrui-ted.Two groups were TPLA (n =69)and SPLA (n =47).And the mean age was 7.26 years in TPLA group and 6.83 years in SPLA group.The mean values of time between onset of abdominal pain to operation,opera-tive duration and length of stay showed no statistical differences.And no inter-group difference existed in patho-logical type according to square test.Conclusions SPLA is both feasible and safe in children.And its definite benefits should be further assessed by randomized controlled trials.%目的：比较采取单孔或常规腹腔镜技术行阑尾切除术的两组病例资料，对其疗效做出客观分析。方法选择由同一主刀医师实施的单孔或常规腹腔镜阑尾切除术患儿病例资料进行回顾性分析，调查内容包括年龄、发病时间、手术时间、住院周期、病理类型等，对比两组治疗效果。结果经由入选标准纳入回顾性调查的儿童急性阑尾炎病例共116例，其中常规腹腔镜组69例，单孔腹腔镜组47例；常规腹腔镜组阑尾切除术采用三孔法，单孔腹腔镜组采用硅胶三孔 Trocar。分析两组年龄、发病时间、手术时间及住院周期数据，两组差异无明显统计学意义。两组阑尾病理类型经卡方检验，组间差异不显著。结论在基于小儿外科医师具备娴熟镜下操作技能前提下，单孔腹腔镜技术完全可能在儿童急性阑尾炎治疗中取代常规腹腔镜手术。