探讨完全经脐部三孔法腹腔镜阑尾切除手术的可行性及美容效果。

958例急性阑尾炎患者随机分为完全经脐部三孔法腹腔镜组（研究组）479例和传统非全部经脐部三孔法腹腔镜组（对照组）479例。比较两组手术的临床指标及术后随访情况，并采用患者问卷方法评价美容效果。

两组手术均顺利完成。研究组和对照组手术时间分别为（48±2.2）min和（30±1.6）min（t=144.819，P<0.01），差异有统计学意义，而术中出血量分别为（15±2.9）ml及（15±2.2）ml，下床活动时间分别为（26±3.1）h及（26±2.1）h，术后肛门排气时间分别为（29±2.1）h及（29±1.6）h，住院时间分别为（3±0.5）d及（3±0.3）d，综合费用分别为（6 589±42）元及（6 591±41）元，差异均无统计学意义。随访时间为1.7~4.8年，两组均无切口感染；止痛药使用频率分别为16.7%（80/479）和17.7%（85/479），差异无统计学意义；患者美容满意度为优的比例分别占99.8%（478/479）和9.8%（47/479），差异有统计学意义（χ²=782.84，P<0.01）。

经脐部三孔法腹腔镜阑尾切除术具有安全可行、腹部美容效果佳等优点，可作为急性阑尾炎的有效治疗方式之一。

To explore the feasibility and cosmetic effect of total transumbilical tract laparoscopic appendectomy.

A total of 958 appendicitis patients were randomly divided into group A (study group) and group B (control group). In group A, 479 patients were treated with total transumbilical tract laparoscopic appendectomy. In group B, the other 479 patients were treated with traditional non-transumbilical tract laparoscopic appendectomy. The clinic effect and the followed-up result were compared. The cosmetic results were scored by the patients.

The operation was successfully performed in all 958 patients. The operating time in group A and B was (48±2.2) min vs (30±1.6) min (t=144.819, P<0.01), the blood loss was (15±2.9) ml vs (15±2.2) ml, the off bed time was (26±3.1) h vs (26±2.1) h, the anus exhausting time was (29±2.1) h vs (29±1.6) h, the hospital stay was (3±0.5) d vs (3±0.3) d, the cost of the operation was (6 589±42) yuan vs (6 591±41) yuan, and the rate of analgesics using was 16.7% vs 17.7%. All the patients were followed-up for 1.7 to 4.8 years (average 2.9 years). There was no incision infection between two groups. The cosmetic satisfaction rate in group A and B were 99.8% vs 9.8% (χ²=782.84, P<0.05).

Total transumbilical tract laparoscopic appendectomy is safe with good cosmetic result. It is effective for the patients with acute appendicitis.