腹腔镜超声刀肠粘连松解术治疗粘连性肠梗阻

目的探讨腹腔镜超声刀在粘连性肠梗阻中的临床应用价值。方法对因粘连性肠梗阻腹腔镜超声刀下肠粘连松解术的27例病人进行回顾性分析，并与同期行电刀下肠粘连松解术的23例患者的治疗结果进行对照。结果27例均顺利完成手术，无中转开腹。手术时间25～135min，术后平均肛门排气排便时间8～26h，住院时间3～5d，无出血、肠漏、腹腔脓肿并发症。结论腹腔镜结合超声刀治疗粘连性肠梗阻具有手术时间短、创伤小、术后恢复快、住院时间短、并发症少等优点，安全实用，而且手术发生再粘连梗阻性机会更少。

Enterolysis using ultrasonically activated scalpel under laparoscopy for adhesive intestinal obstruction

Objective To assess the value of ultrasonically activated scalpel under laparoscopy in treatment of adhesive intestinal obstruction.Methods A total of 27 patients with adhesive intestinal obstruction operated by ultrasonically activated scalpel under laparoscopy in our hospital from Nov.2002 to Dec.2005 were retrospectively analysed and compared with 23 patients who underwent electroscalpel enterolysis at the same period.Results All operations were successfully performed.And none of them converted into laparotomy.The operative duration was 25-135 min(mean 50 min).The time for postoperative flatus-passing and defecation was 8-26 hours.Hospital stay was 3-5 days.No complications such as bleeding,bowel leakage or abdominal abscess were found.Conclusion Enterolysis using laparoscope and ultrasonically activated scalpel to treat adhesive intestinal obstruction is safe and feasible.It has the advantages of short operative time and hospital stay,less invasion and complications,and lower recurrence rate.