- 期刊
Incidental Appendectomy is Unnecessary in Colorectal Surgery: The Experience of a Single Surgeon in a Single Center
大腸直腸手術時附帶闌尾切除是否有必要？單一醫師經驗分享
摘要
目的 在以前的傳統的大腸直腸外科手術中經常施行附帶闌尾切除術，但是其必要性以及帶來的好處目前仍未有定論。我們回顧單一外科醫師15年的手術經驗，試著分析此術式的好處以及可能帶來的併發症方法 我們總共回顧過去15年的病例，分析了701個病人。包括比較病人的基本資料、手術相關的資料、及長期追蹤的臨床資料。結果 病患若接受附帶闌尾切除術並不會增加術後併發症的機率，包含長期腸沾黏併發症也沒有影響。而附帶闌尾切除術並不會有預防將來急性闌尾炎的效果。結論 附帶闌尾切除術是一個相當簡單而且安全的手術，對於術後腸沾黏的發生率並不會增加。但是依我們的經驗，因為老年患者發生急性闌尾炎的機率本來就相當低，附帶闌尾切除術也不會有預防急性闌尾炎的好處。
並列摘要
Purpose. Incidental appendectomies are frequently done during primary colorectal surgery. The benefits and possible adverse side effects of an incidental appendectomy lack evidence; thus, the procedure is controversial. We reviewed the 25-year experience of one specific surgeon in a single center by analyzing the benefits and possible complications, especially adhesion ileus, of incidental appendectomy. Methods. Medical records from 1987 to 2011 were retrospectively analyzed. Emergency operations and right-side colectomies were excluded. Results. We enrolled 701 patients of elective colorectal surgeries (mean age: 63.3 ± 12.2 years old); 106 patients had undergone an incidental appendectomy. There were no significant differences in gender, age, or diagnosis between patients with or without elective appendectomies. There were no significant increase of ileus or decrease it. Conclusion. Incidental appendectomy is a safe procedure without additional risks. It will not increase postoperative ileus, but neither will it decrease the already low incidence of appendicitis after colorectal surgery; therefore, incidental appendectomy did not prove beneficial.