妇科腹腔镜手术中转开腹原因的探讨

Discussion of the Causes of Conversion from Laparoscopic Gynecological Surgery to Laparotomy

目的探讨妇科腹腔镜手术中转开腹原因,旨在找出相对应的预防对策,提高妇科腹腔镜手术成功率。方法选取2011年1月—2015年1月该院妇科接收的腹腔镜手术治疗患者1426例,回顾性研究分析患者手术治疗情况和术中中转开腹情况。结果导致妇科腹腔镜手术中转开腹的原因主要有严重盆腔粘连、损伤性并发症、特殊部位病变、大出血、恶性肿瘤、外科疾病和器械原因,对应的占有比率分别为56.00%、16.00%、8.00%、4.00%、4.00%、8.00%、4.00%;妇科腹腔镜手术中转开腹有25例,中转开腹发生率1.75%,中转开腹主要原因为盆腔严重粘连。结论针对妇科腹腔镜手术中转开腹原因来说,以严重盆腔粘连为主。

Objective To study the causes of conversion from laparoscopic gynecological surgery to laparotomy so as to find the corresponding prevention countermeasures and improve the success rate of laparoscopic gynecological surgery. Methods1426 cases with laparoscopic surgery admitted in the Department of Gynaecology of our hospital from January 2011 to January 2015 were selected. The surgical treatment and intraoperative conversion from laparoscopic gynecological surgery to laparotomy were reviewed. Results The main reasons that caused the conversion from laparoscopic gynecological surgery to laparotomy were severe pelvic adhesion, traumatic complications, special site lesion, massive haemorrhage, malignant tumor,surgical diseases and instrument reason, which accounted for 56.00%, 16.00%, 8.00%, 4.00%, 4.00%, 8.00%, 4.00%, respectively. Of the patients underwent laparoscopic gynecological surgery, 25 cases transferred to laparotomy mainly due to severe pelvic adhesion, the incidence of conversion from laparoscopic gynecological surgery to laparotomy was 1.75%. Conclusion Severe pelvic adhesion is the main reason causes conversion from laparoscopic gynecological surgery to laparotomy.