疑难妇科腹腔镜手术技巧临床探讨

The Clinical study of laparoscopic surgical techniques

目的:减少妇科腹腔镜中转开腹的几率、扩大腹腔镜手术适应证。方法:从4 215例妇科患者中随机选取112例有下腹部开腹手术史且肿瘤较大的患者,并随机分成两组,A组(56例)进行免气与有气腹腔镜联合手术,B组(56例)施行腹腔镜检查后立即中转开腹手术。结果:两组患者均顺利完成手术,两组手术时间无明显差异,A组术后疼痛轻,术后病率低,肛门排气早,住院时间短。结论:免气与有气腹腔镜联合手术可以拓宽妇科腹腔镜手术范围,且安全可靠。

Objective：To reduce the probability of laparoscopic converted to open surgery,laparoscopic surgery to expand indications.Methods：To selected randomly 112 patients among 4 215 cases of gynecological patients who were operated in our hospital from September 2008 to September 2010 with a history of lower abdominal laparotomy and larger tumors,and the 112 patients were divided randomly into two groups.56 patients of group A had free gas and gas combined laparoscopic surgery,56 patients of group B were converted to laparotomy immediately after the implementation of laparoscopy.Results：The patients of the two groups were successfully operated,there were no significant difference between two groups in operative time.The patients of group A had a lighter pain,lower disease rate and earlier bowel,shorter hospital stay after operationConclusion：Gas and a gas-free laparoscopy is safe and reliable and can expand the scope of laparoscopic surgery