腹腔镜小肠切除术的临床应用

Laparoscopic small bowel resection

目的探讨腹腔镜小肠切除术的治疗价值。方法总结分析1993年3月至2000年12月施行的腹腔镜小肠切除术31例患者的临床资料。结果术式包括:腹腔镜辅助下小肠切除术25例;全腹腔镜下小肠切除术6例。25例腹腔镜辅助下小肠切除术平均手术时间(101.9±32.8)min;术中平均出血(65.3±28.5)ml;平均住院(5.5±1.6)d。6例全腹腔镜下小肠切除术平均手术时间(97.2±28.1)min;术中平均出血(59.6±22.1)ml;平均住院(5.1±1.3)d。两组各指标比较,差异均无显著性意义(P>0.05)。所有患者均在术后48d内恢复胃肠功能,并开始下床活动。仅3例术后使用止痛剂。全组手术无病灶遗漏,也无并发症、中转开腹和手术死亡发生。结论腹腔镜小肠切除术具有良好的治疗效果,器械的更新和经验的积累将使这项技术日臻完善。

Objective To evaluate the curative effect of laparoscopic small bowel resection. Methods Data of 31 cases of laparoscopic small bowel resections performed in our hospital from March 1993 to December 2000 were analyzed retrospectively. Results Twenty five patients received the laparoscopy assisted small bowel resection, and 6 the full laparoscopic small bowel resection. Postoperatively pathology types showed:18 patients with leiomyoma, 8 neurofibroma, 3 hamartoma, 1 glomangioma and 1 Meckel′s diverticulum. In the group of laparoscopy assisted small bowel resection, the mean operative time was (101.9±32.8)min (60～150 min), mean blood loss estimated was (65 3±28.5)ml (50～200 ml) and mean hospital stay was (5 5±1 6)days (4～7 days). In the group of full laparoscopic small bowel resection, the mean operative time was (97 2±28 1)min (75～130 min), mean blood loss estimated was (59 6±22 1)ml (50～150 ml) and mean hospital stay was (5 1±1 3)days (5～6 days).There was no differences in the above indexes between the two groups(P >0 05). All the patients could feed and were ambulatory within the second postoperative day. Only 3 patients required postoperative analgesic. No lesions were missed and no operative complications and death occurred.Conclusion Laparoscopic small bowel resection possesses a good therapeutic effect on intestinal diseases.