腹腔镜阑尾切除术中倒“8”字阑尾残端包埋法与荷包包埋法的随机对照研究

张冬辉　庄哲宏　张剑宝

【摘要】 目的：探析腹腔镜阑尾切除术下倒“8”字缝合阑尾残端包埋方法的临床效果。方法：选择于2015年1月-2016年6月到本院进行腹腔镜手术治疗的128例阑尾炎患者作为研究对象，根据术中阑尾残端包埋类型的不同将患者分为两组，观察组66例行腔镜下倒“8”字缝合法包埋阑尾残端，对照组62例行腔镜下荷包缝合法包埋阑尾残端，对两组患者的操作成功率及操作完成时间、术后并发症进行对比分析。结果：经过治疗后观察组包埋操作成功率90.9%，完成操作时间（2.24±0.97）min，并发症9例；对照组包埋操作成功率54.8%，操作完成时间（4.91±1.67）min，并发症11例。两组患者的操作成功率、完成操作时间比较，观察组均优于对照组，差异均有统计学意义（P<0.05）；两组的并发症比较差异无统计学意义（P>0.05）。结论：腔镜下“8”字缝合阑尾残端包埋方法是一种简便易行且安全的阑尾残端包埋方法。

【关键词】 腹腔镜阑尾切除术； 残端包埋

【Abstract】 Objective：To explore the clinical effect of inverted “8” stitching for laparoscopic appendectomy.Method：128 patients with appendicitis who underwent laparoscopic appendectomy in our hospital were selected from January 2015 to June 2016.According to the type of appendectomy，they were divided into two groups，the observation group of 66 patients were given inverted “8” suture to embed appendix stump with laparoscopy， the control group of 62 patients were given purse-string suture to embed appendix stump with laparoscopy.The success rates，completed time of suture， and the postoperative complications of two groups were analyzed.Result：After the treatment，in the observation group the success rate of embedding suture was 90.9%，the suture time was （2.24±0.97）min and the complication were 9 cases；in the control group，the success rate of embedding suture was 54.8%，the time of suture was （4.91±1.67）min and the complication were 11 cases.Compared the success rate and suture time of two groups，the differences were statistically significant（P<0.05）.The complications of two groups was no significant difference（P>0.05）.Conclusion：The method of inverted “8” suture to embed appendix stump for laparoscopic appendectomy is an easy and safe appendix stump embedding method.

【Key words】 Laparoscopic appendectomy； Stump embedding

First-authors address：The Eighth Affiliated Hospital of Sun Yat-sen University，Shenzhen 518033，China

doi：10.3969/j.issn.1674-4985.2017.04.001

腹腔鏡阑尾切除术（LA）是腹腔镜微创手术最早发明的术式之一，早在1983年德国妇科医生Semm就第一次报导了LA[1]。我国于上世纪90年代引进该项手术技术，而后迅速推广，目前已发展成为阑尾切除术的首选术式[2-3]。可以说，有关该术式的各项技术已相当成熟，但有关阑尾残端处理、包埋方面，却一直没有形成约定俗成的常规方法。本院自2015年1月-2016年6月用腔镜下倒“8”字缝合阑尾残端包埋方法处理阑尾残端66例，与同期腔镜下荷包缝合阑尾残端包埋方法处理阑尾残端62例作前瞻性对照研究，得到了较满意的效果，现报告如下。……