腹腔镜手术中应用圈套器联合倒刺线治疗根部坏疽穿孔性阑尾炎的体会OA

Objective:To explore the clinical value and feasibility of the combined application of snare and barbed suture in handling the appendiceal stump during laparoscopic surgery for gangrenous perforated appendicitis at the root.Methods:A retrospective analysis was performed on the clinical data of 30 patients with gangrenous perforated appendicitis at the root admitted between Jan.2022 and Sep.2025.During laparoscopic appendectomy,the gangrenous and perforated appendiceal root was pretreated with a snare to close or reduce the stump,and then the stump was continuously sutured and embedded with 3-0 barbed suture.Operative time,appendiceal stump suture time,intraoperative blood loss,postoperative gastrointestinal function recovery time,drainage tube removal time,postopera-tive hospital stay,and postoperative complications were observed.Results:All 30 operations were successfully completed without conver-sion to open surgery.The mean operative time was(105.07±48.21)min,the appendiceal stump suture time was(18.07±8.59)min,and the intraoperative blood loss was(22.10±13.90)mL.The postoperative gastrointestinal function recovery time was(3.77±1.79)d,the abdominal drainage tube removal time was(6.40±2.59)d,and the mean postoperative hospital stay was(8.70±3.82)d.Postope-ratively,2 patients developed trocar site infections,which were cured by dressing change;2 patients developed abdominal abscesses,which were all cured by irrigation,drainage and anti-infective treatment;no appendiceal stump fistula or intestinal fistula occurred.No long-term complications such as adhesive intestinal obstruction occurred during the follow-up period.Conclusions:The combined appli-cation of snare and barbed suture in the treatment of gangrenous perforated appendicitis at the root is simple,safe,and effective,with re-liable closure of the appendiceal stump,which is worthy of clinical promotion.