Лапароскопічна апендектомія у хірургічному лікуванні гострого апендициту

Relevance of the topic. At the present time laparoscopic appendectomy has taken its own place at the urgent surgery. In spite of this less is studied in the field of the use of the minimally invasive technologies in the cases of complicated acute appendicitis.The aim of research: to investigate the close results of the patients with acute appendicitis treatment with laparoscopic appendectomy, and to compare them with the open appendectomy results; to estimate the possibilities of laparoscopic appendectomy in the cases of complicated acute appendicitis.Materials and methods. The results of surgical treatment of 146 patients with acute appendicitis were analyzed – 59 patients in the main group, who undergone laparoscopic appendectomy, and 80 patients in the control group, who undergone open surgery. 7 patients who passed through conversion were included in the additional group.Results. The frequency of acute appendicitis complications, which were diagnosed during the operation, in the both groups had no significant distinction (50.8 % in the main group and 47.5% in the control group). But 5 patients with diffuse peritonitis and appendicular abscesses needed a conversion of laparoscopic operation into open one, because of the full sanitation necessity and technique difficulties. In the postoperative period among the patients of main group the suppuration of the wound was observed in 2 (3.4%) cases, in the control group – in 10 (12.5%). The average duration of laparoscopic operation was 33.12±2.51 min, open surgery – 66.45±3.33 min. The average hospitalization period in the control group was 6.95±0.2 days and was statistically proved higher than in the main group – 4.72±0.21 days (p≤0.01).Conclusion. Laparoscopic appendectomy can be wide used in the cases of acute appendicitis, including complications, but it can be restricted in the cases of diffuse peritonitis and appendicular abscesses. This minimally invasive surgical operation allows to reduce significantly the duration of operation, the risk of postoperative complications and the average length of staying in the hospital.Цель работы – изучить ближайшие результаты лечения больных с острым аппендицитом при использовании лапароскопической аппендэктомии и сравнить их с результатами лечения пациентов, у которых применяли хирургические вмешательства открытым способом.Материалы и методы. Проанализированы результаты хирургического лечения 146 больных с острым аппендицитом. Основную группу составили 59 пациентов, которым была выполнена лапароскопическая аппендэктомия. В контрольную группу вошли 80 больных, которые были оперированы с использованием открытой аппендэктомии. Остальные пациенты (7 человек), у которых лапароскопическую операцию конвертировали в открытую, составили дополнительную группу.Результаты. Частота выявленных во время операции осложнений острого аппендицита в основной и контрольной группах существенно не отличалась. Однако у 5 больных с распространённым перитонитом и аппендикулярным абсцессом во время лапароскопии были вынуждены воспользоваться конверсией в связи с необходимостью полноценной санации брюшной полости и техническими трудностями. Это несколько ограничивает применение лапароскопической операции при данных осложнениях острого аппендицита. Выводы. Установлено, что лапароскопическая аппендэктомия значительно сокращает продолжительность хирургического вмешательства, уменьшает риск послеоперационных осложнений и сроки пребывания больных в стационаре.Мета роботи – вивчити найближчі результати лікування хворих на гострий апендицит при використанні лапароскопічної апендектомії та порівняти їх із результатами лікування пацієнтів, у яких застосовували хірургічні втручання відкритим способом.Матеріали та методи. Проаналізували результати хірургічного лікування 146 хворих на гострий апендицит. Основну групу становили 59 пацієнтів, яким була виконана лапароскопічна апендектомія. До контрольної групи увійшли 80 хворих, які були оперовані з використанням відкритої апендектомії. Решта пацієнтів (7 осіб), у яких лапароскопічну операцію конвертували у відкриту, становила додаткову групу.Результати. Частота виявлених під час операції ускладнень гострого апендициту в основній та контрольній групах суттєво не відрізнялася. Однак у 5 хворих із поширеним перитонітом та апендикулярним абсцесом під час лапароскопії були вимушені скористатися конверсією у зв’язку з необхідністю повноцінної санації черевної порожнини та технічними труднощами. Це дещо обмежує застосування лапароскопічної операції при таких ускладненнях гострого апендициту.Висновки. Встановлено, що лапароскопічна апендектомія значно скорочує тривалість хірургічного втручання, зменшує ризик післяопераційних ускладнень і строки перебування хворих у стаціонарі

Laparoscopic appendectomy in surgical treatment of acute appendicitis

Relevance of the topic. At the present time laparoscopic appendectomy has taken its own place at the urgent surgery. In spite of this less is studied in the field of the use of the minimally invasive technologies in the cases of complicated acute appendicitis. The aim of research: to investigate the close results of the patients with acute appendicitis treatment with laparoscopic appendectomy, and to compare them with the open appendectomy results; to estimate the possibilities of laparoscopic appendectomy in the cases of complicated acute appendicitis. Materials and methods. The results of surgical treatment of 146 patients with acute appendicitis were analyzed – 59 patients in the main group, who undergone laparoscopic appendectomy, and 80 patients in the control group, who undergone open surgery. 7 patients who passed through conversion were included in the additional group. Results. The frequency of acute appendicitis complications, which were diagnosed during the operation, in the both groups had no significant distinction (50.8 % in the main group and 47.5% in the control group). But 5 patients with diffuse peritonitis and appendicular abscesses needed a conversion of laparoscopic operation into open one, because of the full sanitation necessity and technique difficulties. In the postoperative period among the patients of main group the suppuration of the wound was observed in 2 (3.4%) cases, in the control group – in 10 (12.5%). The average duration of laparoscopic operation was 33.12±2.51 min, open surgery – 66.45±3.33 min. The average hospitalization period in the control group was 6.95±0.2 days and was statistically proved higher than in the main group – 4.72±0.21 days (p≤0.01). Conclusion. Laparoscopic appendectomy can be wide used in the cases of acute appendicitis, including complications, but it can be restricted in the cases of diffuse peritonitis and appendicular abscesses. This minimally invasive surgical operation allows to reduce significantly the duration of operation, the risk of postoperative complications and the average length of staying in the hospital

Laparoscopic appendectomy in surgical treatment of acute appendicitis

Relevance of the topic. At the present time laparoscopic appendectomy has taken its own place at the urgent surgery. In spite of this less is studied in the field of the use of the minimally invasive technologies in the cases of complicated acute appendicitis. The aim of research: to investigate the close results of the patients with acute appendicitis treatment with laparoscopic appendectomy, and to compare them with the open appendectomy results; to estimate the possibilities of laparoscopic appendectomy in the cases of complicated acute appendicitis. Materials and methods. The results of surgical treatment of 146 patients with acute appendicitis were analyzed – 59 patients in the main group, who undergone laparoscopic appendectomy, and 80 patients in the control group, who undergone open surgery. 7 patients who passed through conversion were included in the additional group. Results. The frequency of acute appendicitis complications, which were diagnosed during the operation, in the both groups had no significant distinction (50.8 % in the main group and 47.5% in the control group). But 5 patients with diffuse peritonitis and appendicular abscesses needed a conversion of laparoscopic operation into open one, because of the full sanitation necessity and technique difficulties. In the postoperative period among the patients of main group the suppuration of the wound was observed in 2 (3.4%) cases, in the control group – in 10 (12.5%). The average duration of laparoscopic operation was 33.12±2.51 min, open surgery – 66.45±3.33 min. The average hospitalization period in the control group was 6.95±0.2 days and was statistically proved higher than in the main group – 4.72±0.21 days (p≤0.01). Conclusion. Laparoscopic appendectomy can be wide used in the cases of acute appendicitis, including complications, but it can be restricted in the cases of diffuse peritonitis and appendicular abscesses. This minimally invasive surgical operation allows to reduce significantly the duration of operation, the risk of postoperative complications and the average length of staying in the hospital