LAPAROSKOPIJA NASPRAM OTVORENE APEDEKTOMIJE U TRETMANU AKUTNOG APENDICITISA – NAŠE ISKUSTVO
Sažetak
Akutni apendicitis je jedno od najčešćih abdominalnih stanja koji zahtevaju hiruršku intervenciju. Više od jednog veka otvorena apendektomija je bila zlatni standard kao bezbedna i efikasna procedura za tretman akutnog apendicitisa. U mnogim studijama laparoskopska apendektomija je dokazana kao bezbedna i superiorna metoda . Cilj našeg rada je poređenje rezultata laparoskopske i otvorene apendektomije u smisku trajanja operacije, intrahospitalnog boravka, postoperativnih komplikacija i postoperativnog bola.
Svi bolesnici koji su imali otvorenu ili laparoskopsku apendektomiju u periodu od godinu dana u Centru za minimalno invanzivnu hirurgiju i u Urgentnom centru Univerzitetskog Kliničkog centra u Nišu. Ukupan broj od 126 bolesnika je uključen u retrospektivnu studiju.
Istraživanje je uključilo 126 bolesnika kod kojih je izvršena apendektomija. Laporaskopska apendektomija je urađena kod 58 bolesnika, a otvorena apendektomija kod 68 bolesnika. Prema polnoj distribuciji ispitivane grupe su bile homogene (p = 0,780). Bolesnici od kojih je urađena laporaskopija su nešto mlađi u poređenju sa bolesnicima sa otvorenom apendektomijem, ali bez statističke značajnosti (p = 0,057). Prosečna visina (p = 0,123), težina (p = 0,200) i BMI (p = 0,425) su ujednačeni u obe ispitivane grupe.
Prethodne hirurške operacije su zastupljenije kod OA, ali bez statističke značajnosti (p = 0,141). Procenat bolesnika sa vrednostima WBC > 10 je isti u obe ispitivane grupe (p = 0,927).
Dijabetes mellitus je češći kod pacijenata sa OA, ali bez značajne razlike (p = 0,563).
Akutni i perforirani apendicitisi su podjenako zastupljeni u obe ispitivane grupe (p = 0,490).
Trajanje operacije se nije značajno razlikovalo između ispitivanih grupa (p = 0.751). Hospitalizacija je značajno kraća kod bolesnika kod kojih je urađena laporaskopska apendektomija (p < 0.001).
Tretman akutnog apendicitisa laparoskopskom hirurgijom u poređenju sa otvorenim pristupom daje bolje rezultate u smislu intrahospitalnog boravka, vremena oporavka, postoperativnih komplikacija i postoperativnog bola.
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