背景：Peutz-Jeghers综合征（PJS）患者的小肠多发息肉可引起出血、肠梗阻、肠套叠、息肉恶变等严重并发症,传统外科手术治疗创伤大、术后并发症多,且多次小肠切除术可致短肠综合征.目前关于小切口开腹术中内镜治疗PJS患者小肠息肉的报...背景：Peutz-Jeghers综合征（PJS）患者的小肠多发息肉可引起出血、肠梗阻、肠套叠、息肉恶变等严重并发症,传统外科手术治疗创伤大、术后并发症多,且多次小肠切除术可致短肠综合征.目前关于小切口开腹术中内镜治疗PJS患者小肠息肉的报道较少.目的：探讨小切口开腹术中内镜治疗PJS患者小肠多发息肉的疗效和可能优势.方法：回顾性分析南通市第一人民医院1998年9月-2008年10月7例接受小切口开腹术中内镜治疗的PJS患者的息肉切除情况、手术相关并发症和长期随访结果.结果：7例PJS患者术中共切除929枚小肠息肉,直径≤10 mm 492枚,11～30 mm 377枚,≥30 mm 60枚,最大者45 mm×38 mm.术后2例患者分别出现肠功能障碍和少量便血,1例术后1年内腹部偶有隐痛不适,经治疗后均好转,无严重并发症和死亡病例.随访1～8年,无患者出现需考虑外科手术治疗的病情变化.结论：小切口开腹术中内镜治疗能安全有效地切除小肠多发息肉,可反复治疗而无须切除肠段,对PJS患者具有重要临床应用价值.展开更多
Background: Considering the enormous advantages of minimally invasive surgery, attempts to explore less invasive trans-abdominal incisions could represent an alternative to laparoscopic gynecologic surgery. The aim of...Background: Considering the enormous advantages of minimally invasive surgery, attempts to explore less invasive trans-abdominal incisions could represent an alternative to laparoscopic gynecologic surgery. The aim of this study was to assess the feasibility and clinical outcome of minilaparotomy in a large series of patients. Methods: In this retrospective study we describe our 6-year experience on 252 patients undergoing surgery by minilaparotomy for benign adnexal or uterine disease. Surgical treatments included total abdominal hysterectomy, myomectomy, mono or bilateral salpingo-oophorectomy and adnexal surgery. Results: The mean population age and BMI were 39.2 years (±13.2 S.D.) and 23.6 (±3.31 S.D.), respectively. The mean operative time was 75.4 min (±31.8) and the estimated blood loss was never significant except in two cases (0.8%). The mean duration of ileus was 1.58 days (±0.6 S.D.) and the mean days until discharge were 3.06 (±1.14 S.D.), with a significantly lower duration of recovery in the group of simple adnexal surgery with respect to the others (P = 0.0001). No severe early post-operative morbidity was observed. Conclusions: The current report describes minilaparotomy as a feasible surgical approach in benign gynecological diseases. The operative time is quite similar or shorter than reported for laparoscopy, laparotomy and vaginal surgery. The estimated blood loss is not significant as well as the duration of the ileus and discharge. Moreover, a prospective randomised study, already ongoing in our department, will better answer the question of whether minilaparotomy could be an alternative to laparoscopic and vaginal surgery.展开更多
文摘背景：Peutz-Jeghers综合征（PJS）患者的小肠多发息肉可引起出血、肠梗阻、肠套叠、息肉恶变等严重并发症,传统外科手术治疗创伤大、术后并发症多,且多次小肠切除术可致短肠综合征.目前关于小切口开腹术中内镜治疗PJS患者小肠息肉的报道较少.目的：探讨小切口开腹术中内镜治疗PJS患者小肠多发息肉的疗效和可能优势.方法：回顾性分析南通市第一人民医院1998年9月-2008年10月7例接受小切口开腹术中内镜治疗的PJS患者的息肉切除情况、手术相关并发症和长期随访结果.结果：7例PJS患者术中共切除929枚小肠息肉,直径≤10 mm 492枚,11～30 mm 377枚,≥30 mm 60枚,最大者45 mm×38 mm.术后2例患者分别出现肠功能障碍和少量便血,1例术后1年内腹部偶有隐痛不适,经治疗后均好转,无严重并发症和死亡病例.随访1～8年,无患者出现需考虑外科手术治疗的病情变化.结论：小切口开腹术中内镜治疗能安全有效地切除小肠多发息肉,可反复治疗而无须切除肠段,对PJS患者具有重要临床应用价值.
文摘Background: Considering the enormous advantages of minimally invasive surgery, attempts to explore less invasive trans-abdominal incisions could represent an alternative to laparoscopic gynecologic surgery. The aim of this study was to assess the feasibility and clinical outcome of minilaparotomy in a large series of patients. Methods: In this retrospective study we describe our 6-year experience on 252 patients undergoing surgery by minilaparotomy for benign adnexal or uterine disease. Surgical treatments included total abdominal hysterectomy, myomectomy, mono or bilateral salpingo-oophorectomy and adnexal surgery. Results: The mean population age and BMI were 39.2 years (±13.2 S.D.) and 23.6 (±3.31 S.D.), respectively. The mean operative time was 75.4 min (±31.8) and the estimated blood loss was never significant except in two cases (0.8%). The mean duration of ileus was 1.58 days (±0.6 S.D.) and the mean days until discharge were 3.06 (±1.14 S.D.), with a significantly lower duration of recovery in the group of simple adnexal surgery with respect to the others (P = 0.0001). No severe early post-operative morbidity was observed. Conclusions: The current report describes minilaparotomy as a feasible surgical approach in benign gynecological diseases. The operative time is quite similar or shorter than reported for laparoscopy, laparotomy and vaginal surgery. The estimated blood loss is not significant as well as the duration of the ileus and discharge. Moreover, a prospective randomised study, already ongoing in our department, will better answer the question of whether minilaparotomy could be an alternative to laparoscopic and vaginal surgery.
