腹腔镜手术1500例分析

A REPORT ON 1500 OPERATIONS OF LAPAROSCOPIC

目的:探讨腹腔镜手术适应证选择与并发症的预防。方法:1992年12月1998年8月应用WOLF与STRYKER腹腔镜为1 500例病员进行腹部外科、妇科、胸外科、泌尿外科手术40余种,1 700余例次。其中胆囊切除1 218例次,结、直肠癌切除术15例,其他腹部外科手术124例,妇科手术337例,胸科手术48例,泌尿外科手术9例。结果:中转开放手术11例(0.73％),胆管损伤1例(0.08％),术后大出血4例(0.27％),胸科2例术后死于呼吸衰竭(0.13％)。结论:腹腔镜手术创伤小于传统的开放式手术,但手术指征应严格掌握,先易后难,循序渐进。基础知识、开放手术经验、腹腔镜技能、术中细致耐心是预防手术并发症的四大要素。

Objective: To research the adaption of laparoscopic operation scope and complication prevention.Methods: From December, 1992 to August, 1998, WOLF and STRYKER laparoscopic was used to perform operations on 1500 patients for abolomen surgery, gynecology, chest surgery, which came to more than forty kinds, more than 1700 cases, of them are 1218 cases of cutting off gallbladers, 15 cases colon cancers, 124 cases of other abdomen surgery, 337 cases of gynecology operation, 48 cases of chest surgery, and 9 cases of urology surgery operation.Resullts: Transform opening 11 cases, 0.73%making up; one case of damege to gallbladder, 0.08%making up; 4 cases of blood losing after operation, 0.27%makin up; Two cases of chest surgery died from break down of breath after operating.Conclusion: Demage of Laparoscopic operations are less than the opening operations. However, the instructions on operatio must be strictly followed. Easy case comes first and difficult ones follow. Basic knowledge, the experiences on opening operations, skills, carefulness and patience in operation are four important principles to prevent the operation camplications.