腹腔镜多器官联合手术283例报告

Laparoscopic combined surgery for multiple-organ diseases:a report of 283 cases

目的:探讨腹腔镜多器官联合手术的优势。方法:回顾分析2006年9月至2011年10月为283例患者行腹腔镜多器官联合手术的临床资料,腹腔镜胆囊切除(laparoscopic cholecystectomy,LC)联合胆总管取石T管引流术120例,LC联合肝组织活检术6例,LC+阑尾切除术(laparoscopic appendectomy,LA)66例,LC联合胃穿孔修补术5例,LC+子宫肌瘤切除术15例,LA+子宫肌瘤切除术2例,LC+卵巢囊肿剥除术22例,LA+卵巢囊肿剥除术4例,LC+肝囊肿开窗术8例,LA+肠粘连松解术6例,LC+肠粘连松解术28例,横结肠癌+直肠癌根治术1例。结果:2例中转开腹,余均顺利完成联合手术,术后1例发生切口感染。结论:只要严格把握手术治疗原则及联合手术适应证,腹腔镜联合处理多种腹部病变安全有效,具有患者创伤小、痛苦少、康复快、灵活方便、多病联治的优点。

Objective：To discuss the advantages of laparoscopic combined surgery for multiple-organ diseases.Methods：Clinical data of 283 patients with multiple-organ diseases undergoing laparoscopic surgery from Sep.2006 to Oct.2011 were retrospectively analyzed.The operations included 120 cases of laparoscopic cholecystectomy（LC） and laparoscopic common bile duct exploration and T-tube drainage,66 cases of LC and laparoscopic appendectomy（LA）,15 cases of LC and laparoscopic myomectomy,22 cases of LC and ovarian cystectomy,8 cases of LC and fenestration of liver cyst,6 cases of LA and enterolysis,28 cases of LC and enterolysis,6 cases of LC and liver biopsy,5 cases of LC and gastric perforation repair,2 cases of LA and myomectomy,4 cases of LA and ovarian cystectomy,and 1 case of laparoscopic radical resection of colorectal cancer.Results：Two cases were converted to laparotomy,and all the other surgeries were successful.Incision infection occurred in 1 case.Conclusions：Laparoscopic surgery for multiple-organ diseases is safe and feasible under strict indications and operative principle,has advantages of little trauma and pain,quick recovery,easy operation and simultaneous treatment of multiple diseases.