刮吸解剖法在腹部复杂手术中应用及技巧探讨

目的探讨刮吸解剖法的原理,摸索、总结刮吸解剖法的应用技巧。方法对1997年11月至2006年5月运用刮吸解剖法施行腹部复杂手术2213例进行回顾性分析,对手术成功率,手术持续时间,术中出血量,术后并发症出现情况进行统计分析。结果各种手术均顺利完成解剖分离,无大血管及胆管指伤;胰十二指肠切除术术中平均出血量105ml,平均手术时间3．6h;急性胆囊炎胆囊切除率100％,胃癌根治术术中平均出血量75ml,平均手术时间2．3h,无一例需要术后输血。腹膜后肿瘤手术无一例发生大出血及副损伤。结论彭氏多功能手术解剖器（PMOD）以及延伸而来的刮吸分离解剖法在腹部外科手术中显示了优越性。并且具有独特的技术原理和应用技巧。

The mechanism and clinical applied skills of "curettage and aspiration" technique

OBJECTIVE: To investigate the mechanism of "curettage and aspiration" and to conclude its applied technique. METHODS: 2213 complicated abdominal cases, which operation were performed with the PMOD and its "curettage and aspiration" technique from November 1997 to May 2006, were analyzed retrospectively. Meanwhile, the successful rate of operations, the duration of operation, the blood loss of operation and the postoperative complications were statistically analyzed. RESULTS: Each operation was successfully accomplished without damage of the big blood vessels and the biliary tracts. The mean blood loss of pancreatoduodenectomy and radical gastrectomy for cancer, were respectively 105 ml and 75 ml, the mean duration was respectively 3.6 hours and 2.3 hours. As to the acute cholecystitis, the resectable rafe of gallbladder was 100%. Furthermore, no case needs blood transfusion, no massive hemorrhage and concerned damage happened when performing the operation for retroperitoneal tumor. CONCLUSION: With reasonable operational principles and applied techniques, PMOD (Peng's multifunctional operativedissector) and "curettage and aspiration" technique have demonstrated its specific superiorities in the complicated abdominal operations.