CAJ | 학술논문

目的探讨困难型腹腔镜阑尾切除术的原因以及术中处理技巧.方法回顾性分析102例困难型腹腔镜阑尾切除术患者的临床资料.结果困难原因分别为阑尾周围严重粘连44例、阑尾根部坏疽21例、阑尾解剖位置特殊17例、腹腔内粘连12例、肥胖以及肠道充气8例;96例成功施行腹腔镜阑尾切除术,成功率94.1%(96/102).无肠漏、大出血等严重并发症.结论阑尾周围严重粘连是常见的困难原因,而阑尾根部坏疽是最难处理的.阑尾残端的处理直接影响到手术的成功率及术后并发症发生.
목적 탐토곤난형복강경란미절제술적원인이급술중처리기교.방법 회고성분석102례곤난형복강경란미절제술환자적림상자료.결과 곤난원인분별위란미주위엄중점련44례、란미근부배저21례、란미해부위치특수17례、복강내점련12례、비반이급장도충기8례;96례성공시행복강경란미절제술,성공솔94.1%(96/102).무장루、대출혈등엄중병발증.결론 란미주위엄중점련시상견적곤난원인,이란미근부배저시최난처리적.란미잔단적처리직접영향도수술적성공솔급술후병발증발생.
Objective To study the cause and management of difficult laparoscopic appendectomy.Method A retrospective analysis of 102 difficult laparoscopic appendectomies was performed. Results The associating factors leading to operative difficulty were as follows:adhesion of peri-appendix in 44 cases,gangrene at root of appendix in 21 cases,special location of appendix in 17 cases,abdominal adhesion in 12 cases,obesity and inflatable intestine in 8 cases. Laparoscopic appendectomy was successfully performed in 96 cases(94.1%,96/102) ,and no intestinal leakage or massive hemorrahge occurred. Conclusions Adhesion of peri-appendix is the most common cause in difficult laparoscopic appendectomy,and gangrene at root of appendix is the most difficult one. Reasonable management for appendix stump contributes to successful operation.