165例急性阑尾炎行腹腔镜阑尾切除术的临床体会
Clinical Experience of Laparoscopic Appendectomy in 165 Cases of Acute Appendicitis

目的：探讨急性阑尾炎行腹腔镜阑尾切除术的手术方法与技巧，及其临床应用价值。方法：我院自2021年1月至2022年5月收治的165例急性阑尾炎患者行腹腔镜阑尾切除术，结合患者相关临床资料总结临床经验。结果：所有患者均顺利完成手术，无中转开腹，术后康复出院。手术时间20~80 min，出血量2~30 ml，住院时间3~7 d。术后切口感染2例，盆腔积液2例，均保守治疗痊愈，未出现阑尾残端瘘、盆腔积脓、门静脉炎等严重并发症，术后随访6月，无远期并发症。结论：术前应尽量完善各项检查，明确腹腔及阑尾情况，做到术前心中有数；术者及助手应熟练掌握腹腔镜技术，清楚了解阑尾系统解剖及病理改变，操作时配合默契，总结手术各个步骤细节并完善手术技巧，为急性阑尾炎患者行腹腔镜阑尾切除术是安全可行的，并且能够缩短手术时间，减少手术并发症的发生。
Objective: To investigate the surgical methods and techniques of laparoscopic appendectomy for acute appendicitis and its clinical application value. Methods: 165 patients with acute appendicitis in our hospital from January 2021 to May 2022 underwent laparoscopic appendectomy. Combined with the relevant clinical data, the clinical experience was summarized. Results: All patients successfully completed the operation, with no conversion to open surgery, postoperative recovery and discharge. The operation time was 20~80 min, the blood loss was 2~30 ml, and the hospital stay was 3~7 d. Postoperative incision infection in 2 cases and pelvic effusion in 2 cases were cured by conservative treatment, and there were no serious complications, such as appendiceal stump fistula, pelvic abscess, and portal phlebitis. Postoperative follow-up for 6 months showed no long-term complications. Conclusion: Preoperative examinations should be improved as far as possible to clarify the conditions of abdominal cavity and appendix, so as to have a clear idea before surgery. Operators and assistants should master laparoscopic techniques, have a clear understanding of the anatomy and pathological changes of the appendix, cooperate with each other in operation, summarize the details of each surgical step and improve surgical skills. Laparoscopic appendectomy for patients with acute appendicitis is safe and feasible, and can shorten the operation time and reduce the occurrence of surgical complications.