腹腔镜下多脏器联合手术的临床体会

Clinical experience of combined laparoscopic multi-organ surgery

目的应用腹腔镜技术行腹腔内多脏器联合手术。方法分析10余年来由肝胆外科、妇产科、泌尿外科等联合完成腹腔镜下多脏器联合手术,其中行LC+肠粘连松解术23例,LC+阑尾切除术10例,LC+肝囊肿开窗引流术12例,LC+肝活检术13例,LC+子宫附件手术6例,LC+右肾囊肿去顶术2例,肝囊肿开窗引流+肠粘连松解术3例。结果69例手术均顺利完成,无不可控制的出血,无中转开腹,无术后并发症发生。平均手术时间为100min,单病灶LC为45min;术后平均住院天数为5.2d,LC3.8d。所有患者均在术后36h内下床活动,术后第2天恢复饮食。结论腹腔镜下多脏器联合手术不增加患者痛苦,一次手术同时完成两个病灶,缩短了麻醉、手术和住院时间,从而减轻了患者的经济负担,兼有微创美容的效果。

[Objective] To investigate the Clinical value and experience of combined laparoscopic multi-organ surgery. [Methods] 69 combined laparoscopic multi-organ surgeries including laparoscopic cholecystectomy, laparoscopic treatment of abdominal adhesion, laparoscopic appendectomy, laparoscopic hepatocystotomy, liver biopsy by laparoscope, ovarian cyst and benign teratoma extraction, lapamscopic unroofing of renal cyst were performed from January 1994 to May 2006 by surgeons in Department of Urology, Department of Obstetrics and Gynecology and Department .of Hepatobiliary Surgery. [Results] All laparoscopic procedures were successfully completed. Have no uncontrollable bleeding, no complications were found. The average operation time was 100 minutes, laparoscopic cholecystectomy 45 minutes. Mean postoperative hospitalization was 5.2 days. Laparoscopic cholecystectomy 3.8 days. All the sufferers can leave bed to take activities 36 hours later after operation and recover to eating 2 days later after operation. [Conclusion] Combined laparoscopic multi-organ surgery can be performed conveniently with co-operation of different professional surgeons. It offers significant benefits to patients such as decreased postoperative pain and trauma to the abdominal wall, reduced time of anesthesia, operation and hospitalization, helping cost save, （have a woundless affection for beauty） with effect of making facial.