Abstract 【Objective】To investigate the efficacy and safety of single-port laparoscopy combined with appendix suspension in the treatment of appendicitis in children. 【Methods】A total of 230 children with appendicitis admitted to our hospital from December 2016 to August 2018 were divided into observation group (n=115) and control group (n=115). The observation group was treated with single-port laparoscopy combined with appendix suspension, while the control group was treated with routine laparoscopic surgery. The general conditions of operation (including incision length, operation time, intraoperative bleeding volume.) and the occurrence of complications were compared between the two groups. Visual analogue scale (VAS) was used at 12, 24, 36 and 72 hours after operation to evaluate the pain degree of the two groups. The levels of serum inflammatory stress factors (IL-8, TNF-α) were measured before operation and 1 and 7 days after operation. 【Results】The general conditions of operation in the observation group were significantly better than those in the control group (except operation time, incision length, intraoperative bleeding volume, postoperative exhaust time, hospitalization time, and the use time of analgesics after operation) (P<0.05). The VAS scores of pain in the observation group at 12, 24, 36 and 72 hours after operation were significantly lower than those in the control group at the same time point (P<0.05). The serum levels of IL-8 and TNF-alpha were significantly higher in the two groups at 1 day after operation than those before operation (P<0.05), and gradually decreased at 7 days after operation. The serum levels of IL-8 and TNF-alpha in the observation group were significantly lower than those in the control group at 1, 7 days after operation (P<0.05). There were no short-term and long-term complications such as incision infection, subcutaneous emphysema, residual abdominal infection, adhesive intestinal obstruction and umbilical hernia in both groups. 【Conclusion】Single-port laparoscopy combined with appendix suspension in the treatment of appendicitis in children is safe and feasible. It can significantly alleviate inflammation stress reaction in children. It has advantages of less trauma, faster recovery and fewer complications after operation, and has more aesthetic value than traditional laparoscopic appendectomy.
[1] Dübbers M, Nikolaou E, Fuchs H, et al. Update on transumbilical single-incision laparoscopic assisted appendectomy (TULAA) - which children benefit and what are the complications[J]?Klin Padiatr,2018, 230 (4): 194-199. [2] 吴迅.腹腔镜阑尾切除术与开腹阑尾切除术在阑尾炎治疗中的应用效果比较[J].现代生物医学进展,2016,16(29):5742. [3] Joshi ART. Resident operative experience at independent academic medical centers-a comparison to the national cohort[J].J Surg Educ,2017, 74 (6): e88-e94. [4] 武杰,李超,郑俊全.三孔与单孔腹腔镜微创诊治在外科急腹症中的应用比较[J].现代仪器与医疗,2018,24(6):72-73,84. [5] 刘海龙,曾和平,林谋斌,等.单孔与传统三孔法腹腔镜阑尾切除术治疗成人急性阑尾炎的随机对照研究[J].腹腔镜外科杂志,2017,22(7):536-540. [6] 付志本.改良经脐单孔腹腔镜阑尾切除术的临床分析(附55例报告)[J].腹腔镜外科杂志,2018,23(6):455-457. [7] 邱伟箐,张捷,刘骅,等.经脐单孔与传统三孔腹腔镜阑尾切除术的临床疗效比较[J].外科理论与实践,2017,22(5):443-445. [8] 薛峰,王野,刘志升,等.悬吊式无气腹腹腔镜阑尾切除术在高龄患者中的应用[J].中国中西医结合外科杂志,2016,22(6):589-591. [9] 马丽丽,徐延波,袁正伟.经脐单孔腹腔镜治疗小儿复杂性阑尾炎的疗效分析[J].中国内镜杂志,2017,23(5):13-18.
2020, Vol. 37 
