根部坏疽穿孔复杂阑尾炎的腹腔镜手术治疗体会OACSTPCD

Objective:To explore the application effect of barbed suture in laparoscopic surgery for gangrenous appendicitis with root perforation.Methods:The clinical data of 47 patients with root gangrenous perforated appendicitis who underwent laparoscopic appendectomy from Jul.2020 to Jun.2023 were retrospectively analyzed.There were 28 males and 19 females with the average age of(50.9±14.1)years.47 patients underwent full-layer continuous suture of appendix stump with barbed wire.The intraoperative and postoperative situations and occurrence of complications were observed.Results:All of 47 patients underwent operations successfully without conversion to open surgery.The mean operation time was(82.8±29.1)min,and the average suture time of the appendix stump was(7.6±3.1)min.The intraoperative blood loss was(22.1±11.7)mL.The recovery time of gastrointestinal function,removal time of abdominal drainage tube and postoperative hospitalization time were(35.1±13.8)h,(5.9±2.2)d and(11.1±4.0)d respectively.Postoperative clinical pathological classification included 29 cases of acute gangrenous perforated appendicitis and 18 cases of peria-ppendiceal abscess.After surgery,3 patients experienced incision infection,1 patient suffered from inflammatory mass in the lower right abdomen and 2 patients suffered from abdominal abscess,no appendiceal stump fistula or intestinal fistula occurred in all patients.All 47 patients were followed up for 3-12 months,and no complications such as adhesive intestinal obstruction occurred during the follow-up period.Conclusions:It is safe and effective to use full-thickness continuous suture of the appendix stump with barbed suture in laparo-scopic surgery for gangrenous appendicitis with root perforation,which could reduce the difficulty of laparoscopic suturing.It is worth clinical promotion and application.