| Objective:To compare the clinical effects and their advantages and disadvantages of laparoscopic appendectomy with open appendectomy surgery.Methods:Retrospective analysis from January2002to December2011appendectomy treatment of acute appendicitis in408cases,156cases of laparoscopic appendectomy, open appendectomy252cases; pediatric appendectomy was performed in98cases, including laparoscopic appendectomy33cases of resection,65cases of open appendectomy; older appendectomy performed in54cases,24cases of laparoscopic appendectomy, open appendectomy30cases. Comparison of two surgical incision length, blood loss, operative time, ambulation time, postoperative flatus, postoperative consumption of liquid time, catheter drainage rate and time, use of antibiotics in time, postoperative pain relief drugs usage, incidence of complications, wound infection rate, incidence of abscess, adhesions abdominal pain, the incidence of intestinal obstruction the incidence of hospitalization time and costs.Results:The length of incisions of the traditional open appendectomy group and the laparoscopic appendectomy group were7.34±2.91cm and2.06±0.17cm,95%confidence interval of (4.86,5.79) cm and (2.04,2.09) cm, the difference of the two groups was statistically significant (P<0.05); intraoperative blood loss was26.6±40.7ml and9.23±25.14ml,95%confidence interval (21.56,31.67) ml and (5.25,13.21) ml., the difference between the two groups was statistically significant (P<0.05); operative time was106.13±45.77min and71.85±33.69min,95%confidence interval was (100.15,111.81) min and (66.52,77.17) min and the differ-rence of the two groups was statistically significant (P<0.05); postoperative ambulation time was2.58±1.17days and1.60±0.75days,95%confidence interval was (2.44,2.73) days and (1.42,1.78) days, the difference was statistically significant (P<0.05); postoperative flatus was2.87±1.08days and1.60±0.75days,95%confidence interval of the two groups was (2.44,2.73) days and (1.42,1.78) days, the difference was statistically significant (P<0.05);postoperative eating liquid time was3.17±1.27days and2.06±0.84days,95%confidence interval was (3.01,3.32) days and (1.93,2.19) days, the difference of the two groups was statistically significant (P<0.05); The postoperative abdominal drainage rates were52.3%and32.7%, abdominal drainage time was2.33±2.77days and1.10±2.09days,95%confidence interval was (2.00,2.67) days and (0.77,1.43) days, the difference of two groups was statistically significant (P<0.05); postoperative antibiotic using time were6.34 ±3.80days and3.77±1.86days,95%confidence interval was (5.81,6.87) days and (3.47,4.06) days, the difference was statistically significant (P<0.05); utilization of postoperative analgesics were25%and9%,the difference was statistically significant(p<0.05) complication rates were15.1%and1.9%, incision infection rates were10.7%and1.3%, the incidence of adhesive intestinal obstruction was2.4%and0.6%, the difference was statistically significant (P<0.05); average hospital stay was8.17±5.30days and5.01±2.36days,95%confidence interval was (7.51,8.83) days and (4.63,5.38) days, the difference of the two groups was statistically significant (P<0.05); hospital costs was10,435.14±7535.02yuan and8510.86±3878.38yuan,95%confidence interval was (9500.31,11369.97) yuan and (7897.92,9123.80)yuan, the difference of the two groups was statistically significant (P<0.05).Conclusion:Compared with open appendectomy, Laparoscopic appendectomy is a popular choice for acute appendicitis because of its advantage of minimal insection, shorter operative time, rapid recovery, lower complications, shorter length of hospital stay time, lower hospital cost. And it is can also be used in children and elder. Master the techniques and procedures of laparoscopic appendectomy is the key to laparoscopic appendectomy. |
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