| Objectives To evaluate the advantages and disadvantages of laparoscopic appendectomy(LA)in the treatment of acute suppurative and gangrenous appendicitis.Methods In this study,a retrospective study was conducted to search for all patients undergoing appendectomy in our hospital from January 2011 to December 2015.Among them,449 patients underwent laparoscopic appendectomy and underwent open appendectomy Appendectomy,OA)in 394 patients.Include the standard and exclusion criteria after screening and finally included in the LA group of 270 cases,222 cases of OA group as the research object.The general clinical data of the patients were not statistically significant.The incision length,bleeding volume,operation time,postoperative hospital stay,analgesic use rate,antibiotic use time,intravenous rehydration or vein Nutritional time,intraoperative exploration,drainage tube placement rate and retention time,hospital cost(total cost,postoperative cost),complication(incision infection,intestinal obstruction,abdominal abscess)were compared.Results Patients in the laparoscopic group,275 patients,and 5 patients,were excluded from the study.222 patients with appendectomy;There were no significant differences between the two groups(P> 0.05).There were no significant differences between the two groups(P<0.05).There were no significant differences between the two groups in the laparoscopic group(LA group,2.42 ± 0.18,OA(LA group,9.20 ± 8.85 ml,OA group16.37 ± 14.91ml);laparoscopic group drainage tube placement rate is low,the retention time is shorter(LA group of 38 cases(14.1%),1.66 ± 1.10 days,OA group(68 cases(30.6%),2.56 ± 1.51 days);the difference was statistically significant.The operation time of laparoscopic group was slightly longer(LA group 63.56 ± 33.77,OA group63.24 ± 20.52min),but the difference was not statistically significant.The total cost of hospitalization was slightly higher(LA group 10358.47 ± 1742.12 yuan,OA group8388.86 ± 2111.75 yuan),but the laparoscopic group after surgery but lower(LA group3494.32 ± 1672.91 yuan,OA group 3948.04 ± 2111.75 yuan),the difference was Statistically significant.Laparoscopic group resume above activities early(6.85 ± 2.30 hours,LA group OA group 13.35±9.73 hours),anal earlier recovery exhaust time(15.60±8.72 hours,LA group OA group 21.59±16.32 hours),intravenous fluids or parenteral nutrition laparoscopic time shorter than laparotomy group(1.87±0.69 days,LA group OA group 3.47±1.79 days).Painkillers utilization rate is low(LA group 19.6%,48.7% of OA group),antibiotic use time is short(3.67±1.42 days,LA group OA group 5.74±3.16days),shorter hospitalization time(6.51 ± 3.81 days,LA group OA group 4.50 ± 1.86days),fewer complications(LA group 5 cases(1.9%),OA group of 36 cases(16.2%)),the differences were statistically significant.Conclusions 1 laparoscopy in acute suppurative appendicitis and gangrenous appendicitis in the treatment is safe and effective;2 in the acute suppurative appendicitis and gangrenous appendicitis laparoscopic surgery compared with laparotomy with fast recovery,less bleeding,incision cosmetic effect is good,low complications,short hospital stay and other advantages;3 laparoscopic surgery to carry out early surgery time was significantly longer than open surgery,late surgical time was significantly shorter,or even lower than the open group;4 the total cost of laparoscopic appendectomy was higher than that of laparotomy group.The main cost was laparoscopic new technique,high value consumable and general anesthesia,but the cost was significantly lower than that of laparotomy group.5,laparoscopic appendectomy can be used as the treatment of acute suppurative appendicitis and gangrenous appendicitis,one of the ideal surgical methods can be used in clinical practice. |
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