三级医院腹腔镜阑尾切除术与开放式阑尾切除术的比较研究

A. Koirala, M. Gautam, Sachidanand Shah, D. Adhikari, A. Bhattarai, Ajay Kumar Yadav
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摘要

背景:阑尾切除术是治疗急性阑尾炎最常见的手术方法。腹腔镜和开放式技术均可用于切除。本研究的目的是比较腹腔镜阑尾切除术与开放式阑尾切除术的效果。材料与方法:回顾性研究于2019年4月至2021年2月在尼泊尔比拉特纳格尔诺贝尔医学院和教学医院进行。本研究共纳入90例患者,其中腹腔镜阑尾切除术组44例,开放式阑尾切除术组46例。比较两组患者的人口学特征、手术时间、术后疼痛、住院时间和手术部位感染。结果:90例患者行阑尾切除术,其中腹腔镜组44例,开放组46例,人口学特征相似。腹腔镜组平均手术时间为42.95±2.46 min,开放组平均手术时间为35.25±1.87 min [p<0.001]。腹腔镜组术后8 h平均疼痛为7.77±1.03,开放组为8.45±1.16 [p=0.002];第1天腹腔镜组为5.01±0.88,开放组为5.80±0.99 [p<0.001];第2天腹腔镜组为3.54±1.19,开放组为4.26±0.89[p<0.001]。腹腔镜组平均住院时间为2.02±0.26,开放组平均住院时间为2.52±0.54[p<0.001]。腹腔镜组手术部位感染1例(2.27%),开放组6例(13.04%)[p=0.029]。结论:与开放式阑尾切除术相比,腹腔镜阑尾切除术术后疼痛小,住院时间短,手术部位感染少,手术时间长。
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A Comparative Study of Laparoscopic Appendectomy with Open Appendectomy at a Tertiary Care Hospital
Background: Appendectomy is most common surgical procedure done for treatment of acute appendicitis. Both laparoscopic and open techniques are used for its removal. The aim of this study is to compare the outcome of laparoscopic appendectomy with open appendectomy. Materials and Methods: A retrospective study was conducted in Nobel Medical College And Teaching Hospital, Biratnagar, Nepal from April 2019 to February 2021.Total 90 patients were enrolled in the study of which 44 in laparoscopic appendectomy group and 46 in open appendectomy group. These two groups were compared for demographic profiles, operative time, postoperative pain, length of hospital stay and surgical site infections. Results: Ninety patients underwent appendectomy of which 44 were in Laparoscopic group and 46 in Open group with similar demographic profiles. The mean operative time in Laparoscopic group was 42.95±2.46 minutes where as in Open group it was 35.25±1.87 minutes [p<0.001].The mean postoperative pain at 8 hours in Laparoscopic group was 7.77±1.03 and in Open group 8.45±1.16 [p=0.002], at day one Laparoscopic group 5.01±0.88 and in Open group 5.80±0.99 [p<0.001],at day two Laparoscopic group 3.54 ±1.19 and in Open group 4.26±0.89[p<0.001]. Mean duration of hospital stay in Laparoscopic group was 2.02±0.26 and Open group was 2.52 ±0.54[p<0.001]. Surgical site infections was noted 1(2.27%) in Laparoscopic group and 6(13.04%) in Open group[p=0.029]. Conclusion: Laparoscopic appendectomy offers less postoperative pain, shorter hospital stay, less surgical site infections but prolonged operative time compared to open appendectomy.
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