中国实用外科杂志

中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (03): 249-251.

• 论著 • 上一篇    下一篇

经脐单孔腹腔镜手术102例回顾分析

郑明伟1，秦鸣放2，赵宏志2，戴其利1   

  1. 1 天津医科大学研究生院，天津300100；2 天津市南开医院外三科，天津300100
  • 出版日期:2011-03-01 发布日期:2011-05-30

  • Online:2011-03-01 Published:2011-05-30

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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。

关键词: 微创, 腹腔镜, 单孔

Abstract:

Laparoendoscopic single-site surgery：a retrospective analysis of 102 cases        ZHENG  Ming-wei*,QIN Ming-fang,ZHAO Hong-zhi,et al. *Academy of Postgraduate Student,Tianjin Medical University,Tianjin 300100,China
Corresponding author:QIN Ming-fang,E-mail: dqly2008@126.com
Abstract    Objective    To evaluate the application of laparoendoscopic 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 laparoscopic appendectomy because of severe adhesion（transfer rate 17.65%）. LESS cholecystectomy was performed in 39 patients and 5 of them were converted to four-port laparoscopic cholecystectomy 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 paracentesis. 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 laparoscopic surgery. The operative indications should be controled carefully and it should be performed by experienced laparoscopic surgeons.

Key words: minimally invasive, laparoscopy, single site