1 海南省中医院外二科，海口 570203
2 海南省中医院外一科，海口 570203
Factors influencing adhesive intestinal obstruction after laparoscopic resection of acute appendicitis
CorrespondingAuthor: GAN Lianzhou Email: firstname.lastname@example.org
Foundation: This work was supported by the Scientific Research Project of Health and Family Planning Industry in Hainan Province, China (20A200154).
Objective: To explore and summarize the influencing factors of adhesive intestinal obstruction (AIO) after laparoscopic resection (LA) for acute appendicitis. Methods: The data of 285 patients with acute appendicitis who were successfully treated with LA in the Hainan Hospital of Traditional Chinese Medicine from January 2018 to March 2021 were retrospectively analyzed. According to whether AIO occurred 6 months after operation, they were divided into AIO group (occurrence, n=45) and control group (no occurrence, n=240). The general data and perioperative data of LA in the 2 groups were collected and compared. The risk factors of AIO after LA in patients with acute appendicitis were analyzed by multivariate logistic regression analysis. Results: Univariate analysis showed that the proportions of course of disease >24 h, decrease of albumin (ALB), number of LA operators <60, operation time >1 h and first out of bed activity time >24 h in AIO group were 60.00%, 55.56%, 55.56%, 51.11%, and 44.44% respectively, which were significantly higher than 28.75%, 32.08%, 33.75%, 32.50%, and 26.67% in control group (P<0.05). A total of four of the above five variables entered the logistic regression equation. According to the correlation intensity from high to low, they were LA operation volume <60 (OR=1.749, 95%CI: 1.191 to 3.236), ALB reduction (OR=1.581, 95%CI: 1.127 to 3.014), course of disease >24 h (OR=1.472, 95%CI: 1.108 to 2.538), and hand operation time >1 h (OR=2.015, 95%CI: 1.385 to 4.017). Conclusion: The experience level of LA operators, ALB, course of disease and operation time are the influencing factors of AIO after LA in patients with acute appendicitis. Clinically, the risk of AIO can be evaluated in combination with the above factors, and relevant preventive measures can be taken to reduce the occurrence of AIO.