Clinical Study Of Specimen Extraction Method In Laparoscopic Appendectomy

Objective: To compare the difference of several specimen extraction methods in laparoscopicappendectomy, pick out reasonable and efficient method to guide clinical practice.Methods: According to the experimental design,800patients were underwent laparoscopicappendectomy from2011March to2013February in our department. Divided them into fourgroups, using four different methods,3-L specimen bag, modified glove group, classic specimenbag group and new specimen bag group, take out appendix specimens. Clinical data of extractiontime, the umbilical trocar hole depth, puncture hole infection status and pathological types ofappendix were respectively compared, to compare the difference of puncture hole infection rateand extraction time among different extraction methods.Results: First, the difference of puncture holes infection rate and extraction time among fourextraction methods has statistics significance. Second, five different types of appendicitis wererespectively analysed, compare the difference between different extraction methods. Forchronic appendicitis and acute simple appendicitis, there were no significant differences ofpuncture hole infection rate among four groups, the average extraction time of group and newspecimen bag group was significantly much than other groups. For acute suppurativeappendicits, puncture hole infection rate of glove group significantly much than other groups,extraction time of3-L specimen bag and classic specimen bag group was obviously longer thanother groups. For gangrenous perforative appendicitis, there was no significant difference ofpuncture hole infection rate among four kinds of extraction methods, the extraction time ofclassic specimen bag group and3-L specimen bag group were significantly much than othergroups. For periappendiceal abscess, there was no significant difference of puncture holeinfection rate and extraction time among four kinds of extraction methods.(α=0.05).Conclusions: First, there was significant difference of specimen extraction methods effects onpuncture hole infection rate and extraction time in laparoscopic appendectomy, puncture holeinfection rate of glove group was highest, and extraction time of classic specimen bag was muchthan other groups. Second, each types of appendicitis respectively have relatively reasonablespecimen extraction method, choosing the reasonable specimen extraction method, to reduce thepuncuture hole infection rate, shorten extraction time.