普通器械经脐入路腹腔镜联合手术的临床应用.pdf

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1、·326·JournalofMinimallylnvasiveMedicine，Jun．，2015，Vo1．10，No．3普通器械经脐入路腹腔镜联合手术的临床应用谢晓明(江西宜春市浙赣友好医院普外科，宜春市336000)【摘要】目的探讨普通器械经脐入路腹腔镜联合手术的方法及疗效。方法应用普通腹腔镜器械经脐入路行腹腔镜联合手术28例，其中经脐入路腹腔镜胆囊切除术联合肝囊肿开窗引流术2例，阑尾切除术19例，粘连松解术2例，附件切除术2例，右侧输卵管切除术I例，精索静脉高位结扎术2例。结果28例应用普通腹腔镜器械经脐入路行腹腔镜联合手术均获成功，无中转开腹手术。手术时间50～16

2、0min，平均(85±23．6)min，术中出血1O～40mL，12h后开始进流质饮食，术后住院3～9d，平均(4．5．4-1．4)d。患者均痊愈出院，随访1～24个月，无近期及远期并发症。结论普通腹腔镜器械经脐入路腹腔镜联合手术具有一次麻醉和手术完成多个病变部位治疗的优点，手术安全、有效，切口美观，值得临床推广应用。【关键词】经脐入路；腹腔镜；联合手术【中图分类号】R197．39【文献标识码】A【文章编号】1673-6575(2015)03-0326-03DOI：10．11864／j．issn．1673．2015．03．21Clinicalapplicationoftra

3、nsumbilicallaparoscopiccombinedsurgerywithordinaryinstrumentsXIEXiaoming(DepartmentofGeneralSurgery，ZheganAmiqHospitalYichun，Ywhun336000，Jiangxi，China)【Abstract】ObjectiveToexploretheprocedureandeficacyoftransumbilicallaparoscopiccombinedsurgerywithordinaryinstruments．Methods28patientsunder

4、wenttransumbilicallaparoscopiccombinedsurgerywithordinaryinstruments．Cholecystectomycombinedwithfenestrationanddrainageofhepaticcystwasperformedin2cases，cholecystectomycombinedwithappendectomyin19cases，cholecystectomyCOB—binedwithadhesiolysisin2cases，cholecystectomycombinedwithadnexectomyi

5、n2cases，cholecystectomycombinedwithrightsalpingectomyinonecase，andcholecystectomycombinedwithhighligationofspermaticveinin2cases．ResultsTransumbilicallaparoscopiccombinedsurgerywithordinaryinstrumentswascom-pletedsuccessfullyinallcases．Therewasnoconversiontoopensurgery．Theaverageoperationd

6、urationwas(85±23．6)min[range，(50—160)min]．Theaverageintraoperativebloodlosswas10—40mL．Allpa—tientswereprovidedwithaliquiddiet12hoursafterthesurgery．Theaveragepostoperativehospitalstaywas(4．5±1．4)d[range，(3—9)d]．Thepatientsdischargedaftercompleterecovery．Noshort—termandlong—termcomplication

7、soccurredduringthefollow-upof1to24months．ConclusionsInthetransumbilicallaparoscopiccombinedsurgerywithordinaryinstruments，treatmentformultiplelesionscanbeaccomplishedduringoneoperationwithoneanesthesia．Itisasafeandefectivesurgicalapproachwithcosmeticincisions，