急性复杂性阑尾炎腹腔镜术中不同腹腔处理方法的对照研究OA

Objective:To explore the clinical therapeutic efficacy of different intraoperative peritoneal management methods in laparoscopic appendectomy for acute complicated appendicitis.Methods:A retrospective analysis was performed on the clinical data of 169 patients with acute complicated appendicitis who underwent laparoscopic appendectomy from Jan.2020 to Jan.2024.Among them,56 cases were treated with abdominal irrigation(irrigation group),68 cases with abdominal gauze wiping(gauze group),and 45 cases with combined abdominal irrigation and gauze wiping(combined group).The clinical data of all patients before,during and after surgery were collected and analyzed.Results:There were no statistically significant differences in gender,age,BMI,preoperative white blood cell count,and preoperative neutrophil percentage among the three groups.There was statistically significant difference in operation time among the irrigation group,gauze group,and combined group[(67.00±22.47)min vs.(59.66±16.53)min vs.(74.64±19.17)min,P＜0.001].There were no statistically significant differences in the maximum diameter of the appendix,intraope-rative appendiceal gangrene status,management method of the appendix root,placement of abdominal drainage tube,postoperative hospi-tal stay,recovery time of postoperative inflammatory indicators,total hospitalization cost,or peak postoperative body temperature among the three groups.Conclusions:All three peritoneal management methods can safely and effectively clean the abdominal cavity during laparoscopic appendectomy for acute complicated appendicitis.Among them,the gauze wiping method has shorter operation time than the abdominal irrigation method and the combined irrigation and wiping method and has more advantages in improving surgical efficiency.