腹腔镜联合手术

Combined laparoscopic operation

目的 :探讨腹腔镜联合手术的临床应用价值。方法 :5 1例腹腔镜联合手术的患者中行腹腔镜胆囊切除术加肝囊肿开窗引流术 12例 ,腹腔镜胆囊切除加附件切除术 2例 ,腹腔镜胆囊切除加左肾囊肿开窗引流术 2例 ,腹腔镜胆囊切除加腹腔粘连松解术 35例。均先行腹腔镜胆囊切除 ,再完成腹腔镜下的其他手术。观察术后并发症发生情况、平均住院时间、肠功能恢复时间、下床活动时间和术后疼痛情况等治疗效果。结果 :5 1例腹腔镜联合手术均获得成功 ,无 1例中转开腹 ,无并发症发生。其术后住院时间平均为 (3 5± 1 2 )d ,肠功能恢复时间平均为 (19 9± 9 3)h ,下床活动时间平均为 (2 0 5± 9 9)h ,术后疼痛轻微 ,仅 7例患者需使用镇痛药。医疗费用明显低于 2次手术费用的总和。结论 :只要严格掌握手术指征 ,腹腔镜联合手术能够安全有效地一次性处理 2种或 2种以上腹部病变 ,减轻患者的痛苦 ,节省医疗费用。

Objective:To study the clinical application of combined laparoscopic surgery(CLS).Methods:Fifty one patients were underwent combined laparoscopic surgery. Twelve patients were performed laparoscopic cholecystectomy(LC) plus laparoscopic fenestration of liver cyst(LFLC). Two patients were performed LC plus laparoscopic salpingo ophorectomy. Two patients were performed LC plus laparoscopic fenestration of left kidney. Thirty five patients were performed LC plus laparoscopic adhesiotomy of peritoneal cavity. LC was performed first. The complications, mean times of hospitalization, recovery period of bowel and postoperative pain were observed.Results:The combined laparoscopic surgery of fifty one patients were successful. No complications occured. The mean time of hospitalization was 3.5±1.2 days. Recovery period of bowel was 19.9±9.3 hours after operation. Mean times of leave bed was 20.5±9.9 hours. Postoperative pain was slight and only seven patients need drug.Conclusions:As long as insisting on basic surgical principles and strictly following operative indications for CLS, we can treat multiple abdominal diseases safely and effectively. It can reduce the pain of patients and the cost.