Further Exploring and Discussing Clinical Value of Laparoscopic Appendectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XING Tianyong , ZHAO Xiaobo , REN Yixing , ZHAO Guogang , PENG Xiangyu.

Department of General Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China;

Corresponding author：

Keywords：

Laparoscope; Appendicitis; Appendectomy; Operation

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ObjectiveTo further explore and discuss the value of laparoscopic appendectomy. MethodsThe clinical data of 200 patients underwent appendectomy in this hospital from April 2009 to December 2010 were collected. The operation time, postoperative hospital stay, cost of hospitalization, postoperative anal exhaust time, postoperative pain score, and surgical complications were compared between laparoscopic appendectomy and open appendectomy. ResultsThere were 8 cases conversion to the open approach in this series. The cost of laparoscopic appendectomy was higher than that of open appendectomy (P lt;0.05); the cases of chronic appendicitis, acute simple appendicitis, acute suppurative appendicitis within 36 h of onset treated by laparoscopic appendectomy had shorter operation time, shorter postoperative hospital stay, earlier postoperative anal exhaust time, and slighter postoperative pain than those treated by open appendectomy (P lt;0.05); the differences in postoperative hospital stay, postoperative anal exhaust time, postoperative pain of acute suppurative appendicitis more than 36 h of onset and acute gangrenous appendicitis treated by two types of surgery had no statistical significances (P gt;0.05); the operation time of acute gangrenous appendicitis operated by laparoscopic surgery was longer than that by open appendectomy (P lt;0.05); incision infection rate of laparoscopic appendectomy was lower than that of open appendectomy (P lt;0.05). ConclusionsFor chronic appendicitis, acute simple appendicitis, and acute suppurative appendicitis within 36 h of onset, the outcome and advantages of laparoscopic appendectomy are outstanding, the value of application is clear; and for acute suppurative appendicitis more than 36 h of onset and acute gangrenous appendicitis, laparoscopic appendectomy is difficult and with high rate of conversion, no obvious advantages in recovery after surgery but an increase of medical costs, and the application value is not great.

Citation： XING Tianyong,ZHAO Xiaobo,REN Yixing,ZHAO Guogang,PENG Xiangyu.. Further Exploring and Discussing Clinical Value of Laparoscopic Appendectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(9): 982-986. doi: Copy

1.	Garg CP, Vaidya BB, Chengalath MM.Efficacy of laparoscopy in complicated appendicitis [J]. Int J Surg, 2009, 7(3): 250252.
2.	Richards W, Watson D, Lynch G, et al. A review of the results of laparoscopic versus open appendectomy [J]. Surg Gynecol Obstet, 1993, 177(5): 473480.
3.	Dede K, Mersich T, Zaránd A, et al. Laparoscopic or open appendectomy? [J]. Orv Hetil, 2008, 149(50): 23572361.
4.	杨映弘, 岳晓林, 蔺原, 等. 隐蔽三孔法腹腔镜阑尾切除术192例报告 [J]. 中国普外基础与临床杂志, 2006, 13(5): 591.
5.	宗行万之助. 疼痛的估价－用特殊的视觉模拟评分法作参考(VAS) [J]. 实用疼痛学杂志, 1994, 11(4): 255257.
6.	Sweeney KJ, Keane FB. Moving from open to laparoscopic appendicectomy [J]. Br J Surg, 2003, 90(3): 257258.
7.	Long KH, Bannon MP, Zietlow SP, et al. A prospective randomized comparison of laparoscopic appendectomy with open appendectomy: Clinical and economic analyses [J]. Surgery, 2001, 129(4): 390400.
8.	彭志万, 舒柏荣, 张克难, 等. 电视腹腔镜阑尾切除术1 148例分析 [J]. 中国内镜杂志, 2001, 7(1): 4849.
9.	叶业兴, 黄建武, 金凯, 等. 急性阑尾炎腹腔镜阑尾切除术的临床价值 [J]. 当代医学, 2008, (140): 5758.
10.	龚南雄, 李震宇, 杜玉辉, 等. 腹腔镜阑尾切除术与传统阑尾切除术临床比较分析 [J]. 中国医药导报, 2008, 5(9): 4243.
11.	邓和军, 李庆东, 冉崇新, 等. 腹腔镜阑尾切除术的临床应用价值 [J]. 腹腔镜外科杂志, 2004, 9(4): 241243.
12.	Pandey S, Slawik S, Cross K, et al. Laparoscopic appendicectomy: a training model for laparoscopic right hemicolectomy? [J]. Colorectal Dis, 2007, 9(6): 536539.
13.	李洪树, 陈玉涛, 唐光华, 等. 腹腔镜阑尾切除术应注意的几个问题(附132例报告) [J].　中国普外基础与临床杂志, 2008, 15（5）: 367368.
14.	Sporn E, Petroski GF, Mancini GJ, et al. Laparoscopic appendectomy－is it worth the cost? Trend analysis in the US from 2000 to 2005 [J]. J Am Coll Surg, 2009, 208(2): 179185.
15.	Lamparelli MJ, Hoque HM, Pogson CJ, et al. A prospective evaluation of the combined use of the modified Alvarado score with selective laparoscopy in adult females in the management of suspected appendicitis [J]. Ann R Coll Surg Engl, 2000, 82(3): 192195.
16.	Sauerland S, Lefering R, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis [J]. Cochrane Database Syst Rev, 2004, (4): CD001546.
17.	Leung TT, Dixon E, Gill M, et al. Bowel obstruction following appendectomy: what is the true incidence? [J]. Ann Surg, 2009, 250(1): 5153.
18.	Shalak F, Almulhim SI, Ghantous S, et al. Laparoscopic appendectomy: burden or benefit? A singlecenter experience [J]. J Laparoendosc Adv Surg Tech A, 2009, 19(3): 427429.
19.	张子东. 腹腔镜阑尾切除术58例报道 [J]. 中国普外基础与临床杂志, 2007, 14（1）: 52.
20.	Lintula H, Kokki H, Vanamo K, et al. The costs and effects of laparoscopic appendectomy in children [J]. Arch Pediatr Adolesc Med, 2004, 158(1): 3437.

1. Garg CP, Vaidya BB, Chengalath MM.Efficacy of laparoscopy in complicated appendicitis [J]. Int J Surg, 2009, 7(3): 250252.
2. Richards W, Watson D, Lynch G, et al. A review of the results of laparoscopic versus open appendectomy [J]. Surg Gynecol Obstet, 1993, 177(5): 473480.
3. Dede K, Mersich T, Zaránd A, et al. Laparoscopic or open appendectomy? [J]. Orv Hetil, 2008, 149(50): 23572361.
4. 杨映弘, 岳晓林, 蔺原, 等. 隐蔽三孔法腹腔镜阑尾切除术192例报告 [J]. 中国普外基础与临床杂志, 2006, 13(5): 591.
5. 宗行万之助. 疼痛的估价－用特殊的视觉模拟评分法作参考(VAS) [J]. 实用疼痛学杂志, 1994, 11(4): 255257.
6. Sweeney KJ, Keane FB. Moving from open to laparoscopic appendicectomy [J]. Br J Surg, 2003, 90(3): 257258.
7. Long KH, Bannon MP, Zietlow SP, et al. A prospective randomized comparison of laparoscopic appendectomy with open appendectomy: Clinical and economic analyses [J]. Surgery, 2001, 129(4): 390400.
8. 彭志万, 舒柏荣, 张克难, 等. 电视腹腔镜阑尾切除术1 148例分析 [J]. 中国内镜杂志, 2001, 7(1): 4849.
9. 叶业兴, 黄建武, 金凯, 等. 急性阑尾炎腹腔镜阑尾切除术的临床价值 [J]. 当代医学, 2008, (140): 5758.
10. 龚南雄, 李震宇, 杜玉辉, 等. 腹腔镜阑尾切除术与传统阑尾切除术临床比较分析 [J]. 中国医药导报, 2008, 5(9): 4243.
11. 邓和军, 李庆东, 冉崇新, 等. 腹腔镜阑尾切除术的临床应用价值 [J]. 腹腔镜外科杂志, 2004, 9(4): 241243.
12. Pandey S, Slawik S, Cross K, et al. Laparoscopic appendicectomy: a training model for laparoscopic right hemicolectomy? [J]. Colorectal Dis, 2007, 9(6): 536539.
13. 李洪树, 陈玉涛, 唐光华, 等. 腹腔镜阑尾切除术应注意的几个问题(附132例报告) [J].　中国普外基础与临床杂志, 2008, 15（5）: 367368.
14. Sporn E, Petroski GF, Mancini GJ, et al. Laparoscopic appendectomy－is it worth the cost? Trend analysis in the US from 2000 to 2005 [J]. J Am Coll Surg, 2009, 208(2): 179185.
15. Lamparelli MJ, Hoque HM, Pogson CJ, et al. A prospective evaluation of the combined use of the modified Alvarado score with selective laparoscopy in adult females in the management of suspected appendicitis [J]. Ann R Coll Surg Engl, 2000, 82(3): 192195.
16. Sauerland S, Lefering R, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis [J]. Cochrane Database Syst Rev, 2004, (4): CD001546.
17. Leung TT, Dixon E, Gill M, et al. Bowel obstruction following appendectomy: what is the true incidence? [J]. Ann Surg, 2009, 250(1): 5153.
18. Shalak F, Almulhim SI, Ghantous S, et al. Laparoscopic appendectomy: burden or benefit? A singlecenter experience [J]. J Laparoendosc Adv Surg Tech A, 2009, 19(3): 427429.
19. 张子东. 腹腔镜阑尾切除术58例报道 [J]. 中国普外基础与临床杂志, 2007, 14（1）: 52.
20. Lintula H, Kokki H, Vanamo K, et al. The costs and effects of laparoscopic appendectomy in children [J]. Arch Pediatr Adolesc Med, 2004, 158(1): 3437.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Further Exploring and Discussing Clinical Value of Laparoscopic Appendectomy

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