摘要
目的探讨经脐单孔腹腔镜在普通外科中的应用,总结早期手术经验。方法回顾性分析2008年8月至2010年8月天津市南开医院经脐单孔腹腔镜手术102例病人的临床资料。结果在102例病人中,51例行经脐单孔腹腔镜阑尾切除术,其中9例因粘连严重中转为三孔法操作(中转率17.65%);39例行经脐单孔腹腔镜胆囊切除术,其中5例因暴露困难中转为四孔法手术(中转率10.20%);经脐单孔腹腔镜胆囊切除联合肝囊肿开窗引流术3例,经脐单孔腹腔镜胆囊切除联合阑尾切除术9例,均顺利完成。术后1例病人发现胆总管结石行十二指肠镜取石治疗,2例病人出现胆囊床感染,行腹腔穿刺引流术;无切口感染,无手术相关并发症;术后随访4～24个月,无胆道损伤、出血等并发症。结论经脐单孔腹腔镜手术安全可行,具有微创、美观、疗效确切等优点,手术操作难度较传统腹腔镜手术高,应谨慎把握手术适应证,由经验丰富的腹腔镜医师开展。
Objective To evaluate the application of laparoendoseopic single-site surgery （LESS） in general surgery and summarize initial experience. Methods The clinical data of 102 adult patients performed LESS from August 2008 to August 2010 at Nankai Hospital of Tianjin City were analyzed retrospectively. Results In 102 patients, 51 patients were performed LESS appendectomy and 9 of them were converted to srandard laparoscopie appendectomy because of severe adhesion （transfer rate 17.65% ）. LESS eholecysteetomy was performed in 39 patients and 5 of them were converted to four-port laparoscopic eholecystectomy because of exposing clot＇s tri-angle difficultly （transfer rate 10.20% ）. Three patients were performed LESS cholecystectomy and liver cyst fenestration. Nine patients received combined LESS cholecystectomy and appendectomy. One patient was found common bile duct stone postoperatively and was cured by endoscopic stone extraction. Two patients had gallbladder bed infection and were cured by abdominal paracentesls. There was no wound infection, bile duct injury and bleeding found. In followed-up of 4-24 months, no intestinal obstruction, umbilical hernia, appendix stump inflammation, bile duct stenosis and other complications appeared. Conclusion LESS is safe and feasible, minimally invasive and cosmetic. But the surgical procedures are more difficult than traditional laparoscopie surgery. The operative indications should be eontroled carefully and it should be performed by experienced laparoscopic surgeons.
出处
《中国实用外科杂志》
CSCD
北大核心
2011年第3期249-251,共3页
Chinese Journal of Practical Surgery
关键词
微创
腹腔镜
单孔
minimally invasive
laparoscopy
single site
