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| 在无并发症的急性阑尾炎腹腔镜阑尾残端闭合体外打结缝合和金属内夹的比较 Comparison of extra-corporeal knot-tying suture and metallic endo-clips in laparoscopic appendiceal stump closure in uncomplicated acute appendicitis
亮点 •Secure the appendix stump in laparoscopic appendectomy. •Similar complication rates. •Metallic endo-clip costs higher than extra-corporeal knotting. •Shorter operative times. •安全阑尾残端在腹腔镜阑尾切除术中的应用。 •类似并发症发生率。 •金属内夹成本高于体外打结。 •较短的手术时间。 Abstract 摘要 Background 背景 An adequate closure of the appendiceal stump is vital to minimize intra-abdominal and surgical site infections. There are various techniques for the closure of base of appendix while performing a laparoscopic appendectomy like endoloops, knotting, clips and staplers. 一个适当的阑尾残端闭合是减少腹腔及手术部位感染的重要环节。阑尾切除术的基础上有多种技术，同时进行腹腔镜阑尾切除术像圈套器、打结、夹子、吻合器。 Objective 目的 To compare the extracorporeal knot-tying suture with metallic endoclips in laparoscopic appendiceal stump closure in terms of complications, operative time, hospital stay and cost. 比较打结缝合在并发症发生率、腹腔镜阑尾残端闭合金属夹的体外结手术时间、住院时间和费用方面。 Methodology 方法 This study was conducted as a single-blinded randomized controlled trial. Patients undergoing laparoscopic appendicectomies in three tertiary care hospitals of Peshawar, i.e. Khyber Teaching Hospital, Lady Reading Hospital and Hayatabad Medical Complex from June 1, 2013 to June 1, 2014 were included in the study and randomized into two groups – extra-corporeal knotting group and the metallic endoclip group. Data on demographics, complications, operative time, hospital stay and cost for the two techniques were collected and analyzed. Statistics analyses were done with IBM SPSS v19 (IBM Corp., Armonk, NY, USA). T-test was use for comparison of continuous data; Chi-square test was used for comparison of categorical data. P < 0.05 was considered statistically significant. 这项研究是一个单一的盲随机对照试验。在白沙瓦三个三级医院腹腔镜阑尾切除术患者，即开伯尔教学医院，从2013年6月1日到2014年6月1日，瑞丁夫人医院 （ Lady Reading Hospital ）和哈亚塔堡（Hayatabad）医疗综合大楼的患者纳入研究，随机分为两组–体外打结组和金属血管夹组。收集和分析这两种技术的人口统计学资料、并发症、手术时间、住院时间和费用。统计分析采用SPSS V19（IBM公司，Armonk，NY，美国）。采用T检验进行连续数据的比较，采用卡方检验进行分类数据的比较。P < 0.05被认为有统计学意义。 Results 结果 A total of 68 patients were enrolled in the study and randomized into two groups: metallic endoclip group n = 32 (47.1%), extracorporeal knot group n = 36 (52.9%). The two groups didn't significantly differ in age (P = 0.9). There were no statistically significant differences between the two groups in terms of complication rates (P > 0.05) and hospital stay (P > 0.05). The mean operative time for the endoclip group was shorter (mean 42.1 ± 7.4 min) as compared to the extracorporeal knot group (mean 48.3 ± 8.4 min) (P = 0.002). The cost of endoclip group was higher (800PKR = 8.10US$) as compared to the extracorporeal knot group (220PKR = 2.23US$). 总共有68例患者参加了这项研究，并随机分为两组：金属血管夹N组 = 32（47.1%），体外结N组 = 36（52.9%）。两组年龄上没有显著差异（P = 0.9岁 ）。在并发症发生率方面两组之间差异无统计学意义（P > 0.05）和住院时间（P > 0.05）。对于内镜夹组平均手术时间短（平均42.1 ± 7.4 min），与体外结组相比（平均48.3 ± 8.4 min）（P = 0.002 ）。内镜夹组成本较高（800pkr = 8.10us美元），与体外结组相比（220pkr = 2.23us美元）。 Conclusion 结论 The use of metallic endoclip for appendix stump closure is safe and less time consuming but costs higher. Because of the simplicity of the technique it's a useful alternative to the extracorporeal knotting especially for learners. 对阑尾残端闭合金属血管夹的使用是安全的，耗时少，但成本较高。由于技术在体外打结，尤其是学习者的一个有用的替代性。 Keywords: 关键词： Laparoscopic appendicectomy, Endoclips, Extracorporeal knot, Complication, Cost 腹腔镜阑尾切除术、血管夹，体外结、并发症、费用 原文： http://www.dxye.com/thread-23644-1-1.html |
