복강경 충수절제술과 개복 충수절제술의 비교 고찰 -수술 및 술후 회복의 관점에서-

Abstract

Laparoscopic appendectomy was performed by Kurt Semm, German gynecologist, for incidental appendectomy in gynecologic surgery in 1983. As progressive spreading of the laparoscopic surgery by general surgeons developed, laparoscopic appendectomy was performed for inflammatory appendix whether uncomplicated or complicated. The development of laparoscopic instruments helped surgeons to performed laparoscopic surgery more easily. Nowadays the surgeons who are experienced to laparoscopic surgery prefer laparoscopic appendectomy to open appendectomy. And the patients prefer the laparoscopic appendectomy than open procedure. Laparoscopic appendectomy is an alternative procedure or the procedure of choice for the treatment of acute appendicitis, because it is safe, less invasive, better for recovery and better for the cosmetics. We reviewed our experiences of a hundred and thirty cases of appendectomies, sixty eight cases of laparoscopic appendectomy(LA) and sixty two cases of open appendectomy (OA), performed during ten months from December 1993 to September 1994. One hundred cases of appendectomies performed for nine consecutive months, fifty cases of LA and fifty cases of OA, were compared in intraoperative and postoperative problems. Seventy three cases out of a hundred were followed, and the results were as follows： 1) There was no significant difference between two groups in regard to age and sex. The ratio of male to female was 1 ： 1 in LA group and 1.78:1 in OA group. The mean age was 33.4 years in LA group and 34.8 years in OA group. 2) There was no significant difference between two groups in pathologic findings. The suppurative appendicitis was most common in both groups. 3) The mean operative time was 44.9 minutes in OA and 49.7 minutes in LA, the mean anesthetic time was 72.8 minutes in OA and 82.0 minutes in LA respectively. 4) The hospital stay was shorter in LA group (5.1 days versus 7.2 days), less pain (7.1 daysversus 9.8 days, p=0.413), early exercise (8.1 days versus 14.2 days, p=0.023), return to work (13. 5 days versus 27.6 days, p=0.002) and total fitness (19.2 days versus 35.2 days, p=0.001). 5) Postoperatively, a case of transientk ileus was noted in LA, and two cases of wound infection, 3 cases of hypertrophied incisional scar and a case of ipsilateral inguinal numbness in OA.