探讨使用传统单孔腹腔镜器械实行经阴道阑尾切除术的安全性、可行性及近期疗效，进而评估其临床应用价值。

前瞻性纳入2019年11月至2021年5月间联勤保障部队第九八八医院普通外科收治的女性急性阑尾炎患者30例，15例施行经阴道单孔腹腔镜阑尾切除术为观察组，15例施行传统三孔腹腔镜阑尾切除术为对照组。比较两组手术时间、术中出血量、术后1、2、3天疼痛评分、排气时间、术后并发症、切口满意度、住院时间、住院费用、术后1、3天的血清炎症指标间的差异，同时对观察组术前及术后4、8、12个月性功能进行随访。

30例手术均顺利完成，无中转常规腹腔镜及开腹手术；在出血量（t=-0.410，P=0.685），术后1天（t=-1.720，P=0.096）、3天（t=-0.877，P=0.388）C反应蛋白（CRP）和术后1天（t=-1.797，P=0.083）、3天（t=-0.602，P=0.552）IL-6方面两组差异无统计学意义；在术后1天（t=-3.191，P=0.003）、2天（t=-2.084，P=0.046）疼痛评分，排气时间（t=-2.259，P=0.032），住院时间（t=-3.497，P=0.002）方面观察组要优于对照组；但在手术时间（t=6.231，P<0.001）和住院费用（t=3.276，P=0.003）方面观察组要高于对照组；观察组术后出现并发症2例，对照组1例，两组差异无统计学意义（χ²=0.370，P=1.000）；两组术后1个月随访患者切口满意度均为93.33%；观察组术前及术后4、8、12个月女性性功能指数（FSFI）分别为（25.64±1.60）分、（25.62±1.21）分、（26.09±1.39）分、（26.63±1.30）分，组间比较差异无统计学意义（F=1.759，P=0.166）。

应用传统单孔腹腔镜器械经阴道阑尾切除术是安全、可行的，对术后性功能无影响，近期疗效满意，无痕美容效果确切，是已婚经产妇且美容要求较高阑尾炎患者的可选术式。

To investigate the safety, feasibility and short-term efficacy of transvaginal appendectomy with traditional single-port laparoscopic instruments, and to evaluate its clinical application value.

Thirty female patients with acute appendicitis were prospectively collected from November 2019 to May 2021 at the Department of General Surgery, No.988 Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Army. Fifteen patients underwent transvaginal appendectomy with the single-port laparoscopic instrument as the observation group. Another 15 patients underwent conventional three-port laparoscopic appendectomy as the control. The operation time, bleeding volume, postoperative pain score, postoperativ exhaust time, postoperative complications, incision satisfaction, hospitalization time, hospitalization expenses and postoperative serum inflammation indexes between the two groups were compared. The sexual function (before surgery and 4th, 8th, 12th months after surgery) was observed in the observation group.

All 30 operations were completed without transfer. There were no significant differences in the bleeding volume (t=-0.410, P=0.685), the CRP at 1st (t=-1.720, P=0.096), 3rd (t=-0.877, P=0.388) days and the IL-6 at 1st (t=-1.797, P=0.083), 3rd (t=-0.602, P=0.552) days after the operation. The observation group was superior to the control group in terms of postoperative pain score (1st day: t=-3.191, P=0.003; 2nd day: t=-2.084, P=0.046), first exhaust time(t=-2.259, P=0.032) and hospitalization time (t=-3.497, P=0.002). But the observation group was higher than the control group in the operation time (t=6.231, P<0.001) and the hospitalization expense (t=3.276, P=0.003). Two complications occurred in the observation group and one complication in the control group, there were no statistically significant differences between the two groups (χ²=0.370, P=1.000). The incision satisfaction in the both groups was 93.33% at one month after the operation. The mean FSFI of preoperation and 4th, 8th, and 12th months after operation were (25.64±1.60), (25.62±1.21), (26.09±1.39), (26.63±1.30), there was no statistically significant differences between the groups (F=1.759, P=0.166).

Transvaginal appendectomy with traditional single-port laparoscopic instruments is safe and feasible, has no effect on sexual function. The short-term effect is satisfactory, and the scar-free cosmetic effect is definite. And it is an optional operation for married multipara with higher cosmetic requirements.