복강경 입문기로서의 복강경 충수 절제술의 안정성
Efficacy of a Laparoscopic Appendectomy When Performed by Surgeons Early in Their Laparoscopic Training Courses
주규화, 황상일, 김흥대, 김형욱, 손병호, 한원곤,
소속 상세정보
주규화 ( Joo Kyu-Hwa )
성균관대학교 의과대학 강북삼성병원 일반외과
황상일 ( Hwang Sang-Il )
충주의료원 외과
김흥대 ( Kim Heung-Dae )
성균관대학교 의과대학 강북삼성병원 외과학교실
김형욱 ( Kim Hyung-Ook )
성균관대학교 의과대학 강북삼성병원 일반외과
손병호 ( Sohn Byung-Ho )
성균관대학교 의과대학 강북삼성병원 일반외과
한원곤 ( Han Won-Kon )
성균관대학교 의과대학 강북삼성병원 일반외과
KMID : 0356720100260010017
Abstract
Purpose: Laparoscopic surgery has many advantages and has been a popular method for the treatment of various diseases. Although a laparoscopic appendectomy (LA) is now a common practice, it has not yet become the treatment of choice for appendicitis of inexperienced surgeons in their early days of individual laparoscopic training courses. The purpose of this study was to compare the results obtained by inexperienced surgeons to those obtained by experienced surgeons.
Methods: From May 2007 to January 2008, 130 patients underwent a LA at our department. The surgeries were performed by three surgeons. The patients were divided into 2 groups. In Group I, the LAs were performed by one surgeon who was experienced with laparoscopic procedures, and in Group II, the LAs were performed by two surgeons who were relatively inexperienced with laparoscopic procedures. We retrospectively reviewed patient’s medical records for age, sex, previous abdomen operation history, operation method, operation time, surgical complications, length of hospital stay, and the time to resume soft diet.
Results: The age was younger in Group I (29.8±18.2 vs. 36.0±16.0 yr, P=0.041). The operation time was longer in Group II (48.4±28.7 vs. 64.1±30.0 min, P=0.003). In Group I, wound infections developed in 4 cases. In Group II, wound infections developed in 7 cases, and an intraabdominal abscess developed in 1 case. The differences in conversion rates, times to start of diet, uses of analgesics, and hospital stays were not statistically significant.
Conclusion: Even though an inexperienced surgeon performs the LA for acute appendicitis, there are no differences in postoperative complications and returns to daily activities compared to a LA performed for acute appendicitis by an experienced surgeon. LA is a safe method for the treatment of acute appendicitis for surgeons who are new to laparoscopic procedures.
키워드
충수염; 복강경; 복강경 충수절제술
Appendicitis;Laparoscopy;Laparoscopic appendectomy
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