RESUMO
INTRODUCTION: Appendicectomy is the most common surgical procedure performed in general surgery. This study aimed to compare the outcomes of open appendicectomy (OA), laparoscopic appendicectomy (LA) and single port laparoscopic appendicectomy (SPLA). METHODS: Fifty consecutive patients with suspected acute appendicitis were studied (OA: n=20, LA: n=20, SPLA: n=10). Clinical outcomes were compared between the three groups in terms of operative time, blood loss, postoperative complications, length of hospital stay and cost. RESULTS: Patient demographics were similar among groups (p>0.05). SPLA was characterised by longer operative time (88.1 minutes vs 35.6 minutes in OA and 33.4 minutes in LA) and higher costs (12.84 thousand Chinese yuan [RMB] vs 8.41 thousand RMB in LA and 4.99 thousand RMB in OA). OA was characterised by more blood loss (9.8ml vs 7.5ml in SPLA and 6.8ml in LA), longer hospital stay (7.5 days vs 3.5 days in LA and 3.4 days in SPLA) and lower costs. The total number of complications was higher for OA (n=2) than for LA and SPLA (n=0) although this was not statistically significant. CONCLUSIONS: Where feasible, LA should be undertaken as the initial treatment of choice for most cases of suspected appendicitis.
Assuntos
Apendicectomia/métodos , Apendicite/cirurgia , Laparoscopia/métodos , Doença Aguda , Adolescente , Adulto , Apendicectomia/economia , Apendicite/economia , Perda Sanguínea Cirúrgica , Custos e Análise de Custo , Feminino , Humanos , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Prospectivos , Resultado do Tratamento , Adulto JovemRESUMO
Two widely documented mechanisms of chloride transport across animal plasma membranes are anion-coupled antiport and sodium-coupled symport. No direct genetic evidence has yet been provided for primary active chloride transport despite numerous reports of cellular CI(-)-stimulated ATPases coexisting, in the same tissue, with uphill chloride transport that could not be accounted for by the two common chloride transport processes. CI(-)-stimulated ATPases are a common property of practically all animal cells, with the major location being of mitochondrial origin. It also appears that the plasma membranes of animal cells are sites of CI(-)-stimulated ATPase activity. Recent studies of CI(-)-stimulated ATPase activity and chloride transport in the same membrane system, including liposomes, suggest a mediation by the ATPase in net movement of chloride up its electrochemical gradient across animal plasma membranes. Further studies, especially from a molecular biological perspective, are required to confirm a direct transport role to plasma membrane-localized Cl(-)-stimulated ATPases.