Abstract:
The aim of this study was to compare the clinic outcomes between new single-port laparoscopic appendectomy (NSLA) and conventional three-port laparoscopic appendectomy (CTLA) for patients with acute appendicitis. Patients who were diagnosed with acute appendicitis and underwent appendectomy were retrospectively collected from a single clinical center from September 2021 to June 2023. Baseline characteristics, surgical information, and postoperative information were compared between the NSLA group and the CTLA group. Univariate and multivariate logistic regression analyses were used to find out the predictors of overall complications. A total of 296 patients were enrolled from a single clinical medical center. There were 146 (49.3%) males and 150 (50.7%) females. There were 54 (18.2%) patients in the NSLA group and 242 (81.8%) patients in the CTLA group. After data analysis, we found the patients in the NSLA group had a shorter postoperative hospital stay (P < 0.01) than the CTLA group. The other outcomes including intraoperative blood loss (P = 0.167), operation time (P = 0.282), nature of the appendix (P = 0.971), and overall complications (P = 0.543) were not statistically different. After univariate and multivariate logistic regression analysis, we found that age (P = 0.018, OR = 1.039, 95% CI = 1.007-1.072), neutrophil percentage (P = 0.018, OR = 1.070, 95% CI = 1.011-1.132), and fever (P = 0.019, OR = 6.112, 95% CI = 1.340-27.886) were the predictors of overall complications. However, the surgical procedure (NSLA versus CTLA) was not a predictor of overall complications (P = 0.376, OR = 1.964, 95% CI = 0.440-8.768). Compared with CTLA, there was no significant increase in postoperative overall complications with NSLA, making it a safe and feasible new surgical procedure. More studies are needed to evaluate the long-term results.
摘要:
这项研究的目的是比较新型单孔腹腔镜阑尾切除术(NSLA)和传统三孔腹腔镜阑尾切除术(CTLA)对急性阑尾炎患者的临床疗效。从2021年9月至2023年6月,从单个临床中心回顾性收集诊断为急性阑尾炎并接受阑尾切除术的患者。基线特征,手术信息,比较NSLA组和CTLA组的术后信息。使用单变量和多变量逻辑回归分析来找出总体并发症的预测因素。从单个临床医学中心总共招募了296名患者。男性146例(49.3%),女性150例(50.7%)。NSLA组有54例(18.2%)患者,CTLA组有242例(81.8%)患者。经过数据分析,我们发现NSLA组的患者术后住院时间短于CTLA组(P<0.01)。其他结果包括术中失血(P=0.167),运行时间(P=0.282),附录的性质(P=0.971),总体并发症(P=0.543)无统计学差异。经过单因素和多因素logistic回归分析,我们发现年龄(P=0.018,OR=1.039,95%CI=1.007-1.072),中性粒细胞百分比(P=0.018,OR=1.070,95%CI=1.011-1.132),发热(P=0.019,OR=6.112,95%CI=1.340~27.886)是总体并发症的预测因子。然而,手术操作(NSLA与CTLA)不是总体并发症的预测因子(P=0.376,OR=1.964,95%CI=0.440~8.768).与CTLA相比,NSLA术后总体并发症没有明显增加,使其成为一种安全可行的新外科手术。需要更多的研究来评估长期结果。