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《回顧性分析經(jīng)臍單孔與傳統(tǒng)三孔腹腔鏡膽囊切除術(shù)的臨床療效》由會(huì)員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫(kù)。
1、回顧性分析經(jīng)臍單孔與傳統(tǒng)三孔腹腔鏡膽囊切除術(shù)的臨床療效蔡永旭第一作者兼通訊作者:蔡永旭云南省西雙版納州景洪市勐臘路13號(hào)公安邊防支隊(duì)摘要【目的】回顧性分析經(jīng)臍單孔與傳統(tǒng)三孔腹腔鏡膽囊切除術(shù)的臨床療效【方法】收集2010年01月至2012年05月在我院行腹腔鏡膽囊切除術(shù)患者50例。其中,經(jīng)臍單孔組22例,傳統(tǒng)三孔組28例。比較分析兩組圍手術(shù)期資料?!窘Y(jié)果】50例患者均在腹腔鏡下成功完成手術(shù),無(wú)1例發(fā)生中轉(zhuǎn)開(kāi)腹。兩組患者在術(shù)中出血量和術(shù)后隨訪2年的并發(fā)癥發(fā)生率方面無(wú)統(tǒng)計(jì)學(xué)差異(P>0.05);而在術(shù)后鎮(zhèn)痛例
2、數(shù)、術(shù)后腸道功能恢復(fù)時(shí)間、術(shù)后住院時(shí)間以及手術(shù)時(shí)間上具有統(tǒng)計(jì)學(xué)差異(P<0.05)。【結(jié)論】經(jīng)臍單孔腹腔鏡膽囊切除術(shù)具有優(yōu)于傳統(tǒng)腹腔鏡手術(shù)的美容效果以及術(shù)后疼痛輕、恢復(fù)快等優(yōu)點(diǎn),是一種安全、有效、可行的方法,在將來(lái)可成為一種新型腹腔鏡膽囊切除術(shù)。【關(guān)鍵詞】膽囊切除術(shù);腹腔鏡;經(jīng)臍;單孔;三孔Abstract【Purpose】ARetrospectiveStudytoinvestigatetheclinicaleffectofsingle-incisonandthree-incisionlaparosco
3、piccholecystectomytherapy.【Methods】TheenrolledpatientswiththeCholecystectomywhofromJan,2010toMay,2012,50patientsunderwentlaparoscopiccholecystectomyinourHospital.Therewere22patientsinthesingle-incisiongroupand28patientsintheconventionalthree-incisiongrou
4、p.Collectandcomparetheclinicaldataofthetwogroups.【Results】50casesofoperationsweresuccessfullycompletedwithnobodyconversedtoopenprocedure,andwithnosignificantdifferenceinbloodlossandthepostoperativecomplicationsbetweenthetwogroupsafteraperiodof2years(P>0.
5、05).butinthecasesofthepostoperativeanalgesic,timetakenforresumptionoforalintake,postoperativehospitalstay,operationtimebetweenthetwogroups,withstatisticalsignificance(P<0.05).【Conclusion】TheSILSappearstobecosmeticallysuperiorcomparedtotheconventionalthre
6、e-incisionLAandotheradvantagesincludelesspostoperativepainandfasterpostoperativerecovery.TheSILSisasafe,effectiveandfeasiblemethod,andexpectedtobeapromisingnewtypeofLaparoscopicCholecystectomy.【Keywords】Cholecystectomy;Laparoscopy;Transumbilicus;Single-i
7、ncision;three-incision目前,腹腔鏡膽囊切除術(shù)(laparoscopiccholecystectomy,LC)早已為現(xiàn)代外科所接受,并認(rèn)為是膽囊良性疾病外科治療的“金標(biāo)準(zhǔn)”[1]。其與傳統(tǒng)開(kāi)腹手術(shù)相比較,LC具有更安全、創(chuàng)傷小、疼痛少、恢復(fù)快、住院時(shí)間短、并發(fā)癥少以及術(shù)中可有效探查全腹和盆腔,甚至術(shù)后無(wú)瘢痕等優(yōu)點(diǎn)而在膽囊良性疾病的治療中日益得到廣泛的臨床應(yīng)用和推廣[2、3]。經(jīng)臍單孔腹腔鏡膽囊切除術(shù)(transumbilicallaparoendoscopicsinglesitesu
8、rgerycholecystectomy,TU-LESS-LC)[4]既繼承了經(jīng)自然腔道內(nèi)鏡技術(shù)(naturalorificetransluminalendoscopicsurgery,NOTES)[5]的美容優(yōu)點(diǎn),同時(shí)又降低了NOTES的難度及風(fēng)險(xiǎn),作為單孔技術(shù)獲得了大多數(shù)醫(yī)師的認(rèn)可[1、6],近年發(fā)展很快。本研究分析比較了經(jīng)臍單孔、傳統(tǒng)三孔兩種腹腔鏡膽囊切除術(shù)患者的圍手術(shù)期資料,4發(fā)現(xiàn)前者更具有優(yōu)越性和可行性,現(xiàn)報(bào)道如下:1對(duì)象與方法1