Evaluation Of Curative Effect Of Acute Appendicitis With Root Perforation

Objectives: To explore a surgical method of treatment of acute appendicitis perforated on root,which could reduce postoperative recovery time and incidence of postoperative fecal fistula.Methods: We conducted a retrospective analysis on the clinical operation-related data of 59 patients with acute appendicitis perforated on root,after operation,in the Affiliated Hospital of Hebei University of Engineering from 01/01/2012 to 01/01/2017,all the selected patients met the criteria for selection of the case of this study.According to the difference of the Surgical methods 28 patients were divided into the treatment group and 31 cases were divided into the control group.All patients in the treatment group were treated with the surgical method of appendectomy and simple suture of the seromuscular layer at the perforated site of caecum and covering perforated site with ileocecus appendices epiploicae.All patients in the control group were treated with the surgical method of appendectomy and 8-word suture at the perforated site of caecum.We analyzed and compared the difference between the treatment group and the control group in operative duration,intraoperative bleeding volume,operative incision length,postoperative antibiotic use time,postoperative intestinal function recovery time,postoperative abdominal drainage,postoperative abdominal drainage tube retention time,postoperative analgesic drug use rate,postoperative incision infection rate,Postoperative fecal fistula incidence,average hospitalization time,total hospitalization costs.Results: The duration of operation(min),86.3±14.6 in the Treatment group,84.1±12.9 in the Control group,There was no significant difference between the two groups(P>0.05).The surgical bleeding volume(ml),28±4 in the Treatment group,27±9 in the Control group,there was no significant difference between the two groups(P>0.05);The length of incision(cm),6.5±1.8 in the Treatment group,6.3±2.2 in the Control group,there was no significant difference between the two groups(P > 0.05).The time of using antibiotics after operation(d),3.9±1.7in Treatment group,5.8±1.2 in Control group,there was a significant difference between the two group(P < 0.05).The time of intestinal function recovery(h),33.2±10.8 in the Treatment group,40.8±12.0h in the Control group,there was a significant difference between the two groups(P < 0.05).Average hospitalization time(d),6.5±2.4 in the Treatment group,8.1±3.6 in Control group,there was a significant difference between the two groups(P<0.05).Total hospitalization costs(yuan),7463.1±652.5 in the Treatment group,9498.5±883.8 in Control group,there was a significant difference between the two groups(P<0.05).The percentage of postoperative incision infection(%),7.1% in the Treatment group,9.7% in the Control group,there was no significant difference in the two groups(P> 0.05).The percentage of postoperative fecal leakage,0% in the Treatment group,16.1% in the Control group,there was a significant difference between the two groups(P < 0.05).Conclusions: In the treatment of acute root perforation of appendicitis,it is a safe and effective surgical method that the simple suture at perforation and cover nearby intestinal lipids on the perforation.It can effectively prevent the occurrence of related complication of fecal fistula and cut down postoperative recovery time.