腹腔镜手术安全建立气腹的技术探讨

Techniques in the Establishment of Pneumoperitoneum During Laparoscopic Surgery

目的探讨安全建立气腹的技术和注意事项.方法回顾分析1996年3月至2007年9月4583例腹腔镜建立气腹的临床资料.结果闭合法建立气腹的4526例,成功4500例,成功率99.4%;57例开放法建立气腹均成功;闭合法和开放法建立气腹成功率经X2检验差异无统计学意义.结论认真掌握建立气腹的适应证和操作技巧,闭合法建立气腹是安全的;而开放法是闭合法的有效补充.

Objective To explore the safe techniques in the establishment of pneumoperitoneum during laparoscopic surgery. Methods From March 1996 to September 2007, the clinical data of 4 583 cases received laparoscopic surgery were retrospectively studied. Results We used closed establishment of pneumoperitoneum in 4 526 cases, with a success rate of 99.4% （4 500 cases）. All the 57 cases with open establishment of pneumoperitoneum were successful. There was no significant difference in success rate between the two groups （P 〉 0.05）. Conclusions Strict adhesion to indications of establishment of pneumoperitoneum and appropriate techniques are key factors to ensure a safe closed establishment of pneumoperitoneum. Open establishment is another option in some patients.