Clinical Study On Different Ways To Treating The Mesoappendix In Laparoscopic Appendectomy

Objective:Through clinical comparison of different ways to treat the mesoappendix in laparoscopic appendectomy,analysis of hospitalization costs,postoperative intestinal peristalsis recovery time,operation time,intraoperative bleeding volume,postoperative complications and other related factors,Seeking the methods to reduce the cost of hospitalization in patients,shorten the recovery time of patients,shorten the time required for beginners in LA,so that minimally invasive surgery to get better recognition and developmentin primary hospitals.Methods:Retrospective analysis the clinical data of 121 patients with acute appendicitis underwent laparoscopic appendectomy,the patients were divided into A B C D E five groups according to the different ways to treat the mesoappendixin laparoscopic appendectomy,A:a group of 27 cases of the appendix of the appendix;B: the group B was a single electrode with 12 cases of the appendicitis;C:In group C,30 cases of dipole electrocoagulation of the appendix,D:thirty-four cases of the appendix of the appendix of the silk line were formed by D group,;E:eighteen cases of appendicitis were broken by E group.analysising the perioperative related indicatorsof five groups of patients.Results: The overall comparison of different pathological types of appendicitis :Operation time: Group E>A>C>B>D(P>0.05);hospitalization costs: Group E>A>C>B>D(P<0.05);intraoperative bleeding volume: Group B>D>A>C>E(P<0.05);time of intestinal peristalsis recovery:Group B>C>E>A>D(P<0.05);postoperative complications: there were 3 cases of postoperative hemorrhage of drainage tube in Group B,3 cases of Group D,and no complications occurred in the other groups(P > 0.05).For patients with chronic and acute simple appendicitis appendicitis,Comparison of operative time : A:C ? A:E ? B:D ? B:E ? D:E,t=0.4292?1.6734?0.8157?1.4726?2.5213,all of the P>0.05;A:B?B:C?C:E?A:D ? C:D,t=1.8569 ? 1.8874 ? 2.3131 ? 3.5411 ? 6.1428,all of the P<0.05;Comparison of hospital expenditures:A:B?A:D?A:E?B:E?C:D?C:E?D:E,t=4.0202?5.6920?8.3119?5.3631?5.6920?9.1907?20.8321,all of the P<0.005A:C ? B:D ? B:C,t=3.0455 ? 2.2665 ? 1.9055,all of the P<0.05;Comparison of intraoperative blood loss : A:B ? A:D ? A:E ? B:C ? B:E ? C:D ? C:E ? D:E,t=8.3820 ? 5.9687 ? 9.6608 ? 7.3684 ? 13.294 ? 5.2291 ? 12.117 ? 8.4072,all of the P<0.005;A:C,t=2.2618,P<0.05;B:D,t=0.42791,P>0.05;Comparison of recovery time of intestinal peristalsis : A:B ? A:C ? A:E ? B:E ? C:D ? D:E,t=3.3676?4.0029?2.9973?4.3195?6.3663?7.6109,all of the P<0.0005;A:D,t=2.9973,P<0.005;B:C ? B:D ? C:E,t=0.87127 ? 0.32526 ? 1.3719,all of the P>0.05;Through the comprehensive analysis of the observed indicators,for patients with chronic appendicitis and acute appendicitis,laparoscopic appendectomy in treatment of mesenteriolum,with silk ligature or monopolar electrocoagulation treatment has more advantages in laparoscopic appendectomy.appendix mesangial in laparoscopic appendectomy processing,by silk thread ligation or by unipolar electric coagulation treatment appendix mesangial have more advantages.For Patients with acute purulent appendicitis and gangrenous perforated appendicitis,Comparison of operative time : A:C ? A:E ? B:C ? B:E ? D:E ? C:D,t=4.0261 ? 2.5734 ? 5.7934 ? 9.8412 ?5.51368?3.4672,all of the P<0.005;A:B?C:E?A:D?B:D,t=1.0124?0.96446?0.53218?1.0415,all of the P>0.05;Comparison of hospital expenditures:A:B?A:D ? A:E ? B:E ? C:D ? C:E ? D:E,t=3.1341 ? 4.3720 ? 9.0239 ? 5.8546 ?3.651820 ? 10.251 ? 18.943,all of the P<0.005;A:C ? B:D ? B:C,t=3.7567 ?2.6324?2.3467,all of the P<0.05;Comparison of intraoperative blood loss:A:B?A:D ? A:E ? B:C ? B:E ? C:D ? C:E ? D:E,t=7.4534 ? 5.0867 ? 10.334 ? 8.3312 ?15.873 ? 7.2123 ? 7.3158 ? 21.0587,all of the P<0.005;A:C ? B:D,t=1.3578 ?0.42791,all of the P>0.05;Comparison of recovery time of intestinal peristalsis:A:B?A:C?A:E?B:D?C:D?D:E,t=3.9825?5.3523?2.6587?9.6967?13.178?5.8935,all of the P<0.005;A:D? B:C?B:E?C:E,t=1.3095?0.5735?0.32967?1.0437,all of the P>0.05;For the treatment of acute suppurative appendicitis with monopolar electrocoagulation in laparoscopic appendectomy,3 cases of postoperative abdominal drainage fluid bleeding,gangrenous appendicitis with suture ligation in laparoscopic appendectomy,3 cases of postoperative abdominal drainage bleeding liquid,this study found that these two kinds of pathology type of appendicitis available bipolar coagulation or ultrasonic scalpel in laparoscopic appendectomy treatment,the operation is relatively easy,relatively short operative time,postoperative complication rate dropped to the lowest.Conclusion:Different pathological types of appendicitis,using the method of treatment of mesangial relatively appropriate,not only can spend less surgical complications and hospitalization of patients,shorten the recovery time of patients,it can make the better development of minimally invasive surgery in primary hospital.