腹腔镜在腹部多脏器联合手术中的应用

Clinical application of combined multi-disciplinary laparoscopic surgery

目的：总结妇科子宫以及附件良性疾病合并外科疾病经腹腔镜联合手术治疗的效果。方法：对43例子宫以及附件良性病变合并胆囊结石、阑尾炎以及肠粘连的患者，选择腹腔镜联合手术，术中行子宫切除、子宫肌瘤剔除、卵巢囊肿剥除术，同时行胆囊切除、肠粘连松解以及阑尾切除术，术中常规病理检查。结果：手术时间40～178min，平均（72．0±8．6）min；术中出血（5—120）ml；术后住院（4～7）d，平均（5．4±1．2）d。术后肠功能恢复时间（64～8）h，平均24h。43例手术均获得成功，无一例中转开腹，无相关并发症发生。结论：多脏器腹腔镜联合手术安全有效，充分体现了微创外科的优越性，但应严格掌握手术适应证。

Objective To observe the effect of combined multi-disciplinary laparoseopie surgery on benign gyneco- logical diseases complicating with surgical diseases. Methods Forty-three patients with benign gynecological diseases complicating with surgical diseases ,such as cholecystolithiasis, appendicitis, ankylenteron etc. , were selected to be trea- ted with combined multi-disciplinary laparoscopic surgery. Uterectomy, uterus myoma and ovarian cyst resection were per- formed meanwhile gall bladder resection, enterolysis and appendix resection were performed too. Biopsy during operation was routinely performed. Result Operation time lasted 40 ± 178 min, averaging （72 ± 8.6） min; bleeding during oper- ation was 5 ~ 120 ml; time in hospital after operation was 4 ~ 7 d, averaging （5.4 ± 1.2 ） d and bowel function recovered in 6 -48 h after operation, averaging 24 h. Post-operation pain was slight and could be tolerated. Every operation was successful, no expanding operation needed and no complications occurred. Conclusion Combined multi-disciplinary laparoscopie surgery was safe and effective, showing the advantage of microsurgery. However, patient indication should be strictly applied.