{"title":"腹腔镜阑尾切除术中的中盲肠固定:结扎与测量","authors":"Mahmoud Abdelhameid, Mohamed Abdelshafy, A. Taha","doi":"10.21608/ejsur.2024.357134","DOIUrl":null,"url":null,"abstract":"Background: Securing the mesoappendix during appendectomy is a crucial step in this procedure. The current study aimed to evaluate the perioperative outcomes of intracorporeal ligation versus Ligasure in securing the mesoappendix during laparoscopic appendicectomy (LA). Patients and Methods: A prospective randomized comparative study was carried out in a tertiary care hospital. Patients who had laparoscopic appendectomy for acute appendicitis between January 2021 and January 2024 were included in this study. Patients were allocated to one of two groups. Group I: the mesoappendix was secured by intracorporeal suture ligation. Group L: the mesoappendix was secured by LigaSure. Demographic and perioperative data were collected, tabulated, and analyzed by SPSS 23. Results: A total of 100 patients underwent LA. No statistically significant difference was found between the two groups regarding age, sex ratio, or BMI. The technique duration was 8.9±3.5 min in group I, while the duration was 4.9±2.3 min in group L (statistically significant difference P≤0.05 ). None of the patients required conversion to an open surgery. The duration of postoperative hospital stay was 12.1±2 h for group I, and 11.1±8 h for group L ( P>0.05 ). One (2%) patient in group I had a postoperative right iliac fossa-infected hematoma. In group L, there was no postoperative complications. Conclusion: In LA, the incidence of perioperative complications is not affected by the method used for securing the mesoappendix. However, intracorporeal ligation takes a longer time, which could be improved with training, it is cost-effective, safe, and suitable when energy-sealing devices are not available or in low-resource facilities.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"5 2","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Securing Mesoappendix during Laparoscopic Appendicectomy: Ligation vs. Ligasure\",\"authors\":\"Mahmoud Abdelhameid, Mohamed Abdelshafy, A. Taha\",\"doi\":\"10.21608/ejsur.2024.357134\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Securing the mesoappendix during appendectomy is a crucial step in this procedure. The current study aimed to evaluate the perioperative outcomes of intracorporeal ligation versus Ligasure in securing the mesoappendix during laparoscopic appendicectomy (LA). Patients and Methods: A prospective randomized comparative study was carried out in a tertiary care hospital. Patients who had laparoscopic appendectomy for acute appendicitis between January 2021 and January 2024 were included in this study. Patients were allocated to one of two groups. Group I: the mesoappendix was secured by intracorporeal suture ligation. Group L: the mesoappendix was secured by LigaSure. Demographic and perioperative data were collected, tabulated, and analyzed by SPSS 23. Results: A total of 100 patients underwent LA. No statistically significant difference was found between the two groups regarding age, sex ratio, or BMI. The technique duration was 8.9±3.5 min in group I, while the duration was 4.9±2.3 min in group L (statistically significant difference P≤0.05 ). None of the patients required conversion to an open surgery. The duration of postoperative hospital stay was 12.1±2 h for group I, and 11.1±8 h for group L ( P>0.05 ). One (2%) patient in group I had a postoperative right iliac fossa-infected hematoma. In group L, there was no postoperative complications. Conclusion: In LA, the incidence of perioperative complications is not affected by the method used for securing the mesoappendix. However, intracorporeal ligation takes a longer time, which could be improved with training, it is cost-effective, safe, and suitable when energy-sealing devices are not available or in low-resource facilities.\",\"PeriodicalId\":22550,\"journal\":{\"name\":\"The Egyptian Journal of Surgery\",\"volume\":\"5 2\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Egyptian Journal of Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.21608/ejsur.2024.357134\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Egyptian Journal of Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21608/ejsur.2024.357134","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:在阑尾切除术中固定阑尾系膜是手术的关键步骤。本研究旨在评估腹腔镜阑尾切除术(LA)中体外结扎与 Ligasure 在固定阑尾系膜方面的围手术期效果。患者和方法:在一家三级医院开展了一项前瞻性随机对比研究。本研究纳入了 2021 年 1 月至 2024 年 1 月期间因急性阑尾炎而接受腹腔镜阑尾切除术的患者。患者被分配到两组中的一组。I组:通过体腔内缝合结扎固定阑尾系膜。收集人口统计学和围手术期数据,制成表格,并使用 SPSS 23 进行分析。结果共有 100 名患者接受了 LA 术。两组患者在年龄、性别比例或体重指数方面无统计学差异。I 组的技术持续时间为(8.9±3.5)分钟,而 L 组为(4.9±2.3)分钟(差异有统计学意义,P≤0.05)。没有患者需要转为开放手术。I 组术后住院时间为(12.1±2)小时,L 组为(11.1±8)小时(P>0.05)。I 组有一名(2%)患者术后出现右髂窝感染性血肿。L 组没有术后并发症。结论在 LA 中,围手术期并发症的发生率不受固定阑尾中段方法的影响。然而,体外结扎需要较长的时间,这一点可以通过培训得到改善,但它成本低、安全,适用于没有能量密封装置或资源匮乏的医疗机构。
Securing Mesoappendix during Laparoscopic Appendicectomy: Ligation vs. Ligasure
Background: Securing the mesoappendix during appendectomy is a crucial step in this procedure. The current study aimed to evaluate the perioperative outcomes of intracorporeal ligation versus Ligasure in securing the mesoappendix during laparoscopic appendicectomy (LA). Patients and Methods: A prospective randomized comparative study was carried out in a tertiary care hospital. Patients who had laparoscopic appendectomy for acute appendicitis between January 2021 and January 2024 were included in this study. Patients were allocated to one of two groups. Group I: the mesoappendix was secured by intracorporeal suture ligation. Group L: the mesoappendix was secured by LigaSure. Demographic and perioperative data were collected, tabulated, and analyzed by SPSS 23. Results: A total of 100 patients underwent LA. No statistically significant difference was found between the two groups regarding age, sex ratio, or BMI. The technique duration was 8.9±3.5 min in group I, while the duration was 4.9±2.3 min in group L (statistically significant difference P≤0.05 ). None of the patients required conversion to an open surgery. The duration of postoperative hospital stay was 12.1±2 h for group I, and 11.1±8 h for group L ( P>0.05 ). One (2%) patient in group I had a postoperative right iliac fossa-infected hematoma. In group L, there was no postoperative complications. Conclusion: In LA, the incidence of perioperative complications is not affected by the method used for securing the mesoappendix. However, intracorporeal ligation takes a longer time, which could be improved with training, it is cost-effective, safe, and suitable when energy-sealing devices are not available or in low-resource facilities.