腹腔镜阑尾切除术与开腹阑尾切除术的对比分析

目的 本文主要分析腹腔镜阑尾切除术（LA）与开腹阑尾切除术（OA）的比较.方法选取我院于2013年3-9月期间收治62例急慢性阑尾炎的临床资料,随机分为两组-观察组与对照组,每组31例,给予对照组患者行开腹阑尾切除术治疗,同时给予观察组患者行腹腔镜阑尾切除术治疗,对比两组患者的手术时间、术中出血量以及并发症等.结果 观察组患者的手术时间、术中出血量、排气时间、并发症发生率均优于对照组,差异明显,有统计学意义（P＜0.05）.结论与OA相比,LA的操作简便、安全可靠、疗效显著、并发症发生率低,值得推广.     

腹腔镜及开腹术式对慢性阑尾炎患者疼痛及腹腔粘连的影响

目的结合临床实践经验,探讨腹腔镜及开腹术式对慢性阑尾炎患者疼痛及腹腔粘连的影响。方法按照手术方式的不同,将患者分为开腹手术组（67例）和腹腔镜手术组（65例）。两组患者在性别、年龄、病情等一般资料方面差别无统计学意义（P〉0．05）,具有可比性。通过对比两组患者在术中、术后的情况及处理,并随访患者慢性腹痛以及肠粘连的情况,探讨其临床应用价值。结果术中出血、住院时间、术中粘连以及术后疼痛比较中,开腹手术组和腹腔镜组两组差异有统计学意义。手术时间比较中两组差异无统计学意义。结论腹腔镜组术中出血与住院时间明显少于开腹手术组,提示腹腔镜手术术中出血少、住院时间短的优点。腹腔镜能对腹腔内进行彻底的探查,更多的发现患者腹腔内粘连并治疗,术后慢性疼痛少于开腹手术组,具有明显的优势,值得临床推广。     

腹腔镜阑尾切除术治疗急慢性阑尾炎的效果观察

目的通过观察天津南开医院,天津海河医院收治的阑尾炎疾病患者的临床资料,探讨分析使用腹腔镜阑尾切除术治疗该类疾病的临床效果。方法选取两所医院收治的100例阑尾炎患者,均包括急性阑尾炎及慢性阑尾炎,将所选患者分为腹腔镜手术治疗组（LA组）与开腹手术治疗组（OA组）,每组均50例,对两组的相关临床治疗过程资料进行回顾性对比分析。结果本次研究的LA组患者手术所用时间为（42．6±9．8）min,平均住院所用时间为（4．3±1．5）d,与OA组相比差异有统计学意义,此外在术中出血量、术后排气时间,以及术后并发症发生情况方面,两组差异均具有统计学意义,且LA组患者治疗前后效果对比显著。结论采用腹腔镜手术治疗阑尾炎疾病,具有安全可靠性高、手术疤痕小、创伤轻微、手术时间短、伤口感染率低以及病情恢复快等诸多优点,可以避免传统开腹手术的一些弊端,产生的临床效果显著,值得临床上进一步推广研究与应用。     

Laparoscopic intervention in pediatric urology]

The authors summarise the short history of the laparoscopy, and main steps of its use in international and Hungarian practice of urological surgery. They evaluate the possibility of laparoscopy in paediatric urological practice. Finally, they present their experience with this minimally invasive technique from 1995. Between October 1995 and September 1998, 83 laparoscopic procedures were performed. In 59 patients the vena testicularis were ligated by laparoscopy and in 22 patients 24 non palpable testes were diagnosed and operated. In 9 of the cases laparoscopic orchidopexy was performed. The authors demonstrate their operative technique. All laparoscopic interventions were tolerated well by children and they were treated without any complication. Postoperative pain medication were given for 5 children. The operative time for varix ligation ranged from 15 and 20 minutes, and for laparoscopic orchidopexy from 30 and 40 minutes. The recurrence rate of varicocele was found to be 1.5%, and postoperative hydrocele developed in one patient (1.5%).     

Laparoscopic cholecystectomy. Initial experiences]

Between February 1991 and July 1991, 74 laparoscopic cholecystectomies were performed. The number of all cholecystectomies during this period was 168. Two surgeons performed the operations. Stone in the common bile duct, old age, acute cholecystitis, severe obesity and heart rhythm disorders were regarded as contraindications. The duration of the operation was 45-210 min. (mean 127 min). The intervention was diverted to open cholecystectomy in 2 instances (2.7%). Early postoperative complications were observed in 2 cases (2.7%): biliary discharge and bleeding. Reoperation was necessary in one patient (1.3%) because of bleeding. There was no operative mortality. The mean duration of hospitalization was 5.6 days, and the mean postoperative period was 2.7 days. It is considered that, laporoscopic cholecystectomy can be carried out only by specialists in both bile surgery and laparoscopic techniques, provided that all the personal and technical conditions necessary for traditional cholecystectomies are at hand. Both medically and economically, the laparoscopic cholecystectomy results attain or even exceed those of the traditional open technique.     

腹腔镜阑尾切除与开腹阑尾切除对比

目的 探讨腹腔镜阑尾切除术（LA）的可行性。方法 对2003年5月～2005年5月收治的145例LA患者与2001年6月～2003年3月收治的142例开腹阑尾切除术（OA）患者在治疗阑尾炎的疗效方面进行回顾性综合分析。结果 LA组与OA组在手术操作时间上差别无统计学意义；LA组在切除阑尾的同时可以发现和治疗其他隐性疾病，OA组则无此作用；在术后使用镇痛药、术后下床活动时间、切口感染发生率、住院时间等项中，LA组明显优于OA组；平均住院费用LA组高于OA组。结论 LA在治疗阑尾炎上有明显优势，值得推广。     

腹腔镜阑尾切除与开腹阑尾切除对比

目的探讨腹腔镜阑尾切除术(LA)的可行性。方法对2003年5月~2005年5月收治的145例LA患者与2001年6月~2003年3月收治的142例开腹阑尾切除术(OA)患者在治疗阑尾炎的疗效方面进行回顾性综合分析。结果LA组与OA组在手术操作时间上差别无统计学意义;LA组在切除阑尾的同时可以发现和治疗其他隐性疾病,OA组则无此作用;在术后使用镇痛药、术后下床活动时间、切口感染发生率、住院时间等项中,LA组明显优于OA组;平均住院费用LA组高于OA组。结论LA在治疗阑尾炎上有明显优势,值得推广。     

腹腔镜与开腹行阑尾切除术的临床对比分析

目的 对比分析腹腔镜(LA)和开腹行阑尾切除术(OA)的手术效果.方法 选取我院2007年4月至2011年3月48例腹腔镜阑尾切除术和54例开腹阑尾切除术,比较不同术式的出血量、手术时间、术后排气时间、切口感染率、住院时间、术后并发症发生情况.结果 LA组的手术时间、术后排气时间、住院时间明显短于OA组,术中出血量、切口感染率、术后并发症发生率低于OA组,其差异有统计学意义(P＜0.05).结论 LA治疗阑尾炎疗效确切,具有创伤小、恢复快、住院时间短、并发症发生率低等优点,在无禁忌证的情况下,逐渐成为阑尾切除的首选手术方式之一.     

Laparoscopic cholecystectomy in The Netherlands: early national results]

The results of laparoscopic cholecystectomy in 58 of the 66 hospitals in which surgeons introduced this method after attending a practical course are evaluated. Data of 546 patients were collected. The indication for laparoscopic surgery was symptomatic gallstone disease without evidence of common bile duct stones, cholecystitis or previous upper abdominal surgery. In 70% of the 58 hospitals fewer than 10 laparoscopic cholecystectomies were performed nine months after the first practical course because of shortage of equipment. The mean age was 50 years (range 20-80) with a male:female ratio of 1:4. The average operation time was 95 minutes. In 8.2% of the patients the laparoscopic procedure was converted to laparotomy. Adhesions, cholecystitis or difficulty in recognition of the anatomy was responsible for the conversion in 31 of the 45 patients. In the remaining 14 patients bleeding or bile leakage during the procedure compelled the surgeon to perform a laparotomy. One patient died because of bleeding from the cystic artery. Eleven patients underwent laparotomy postoperatively because of bleeding (3), bile leakage (6) and lesion of the ductus choledochus (2). Minor complications occurred in 30 patients. Laparoscopic cholecystectomy is expanding rapidly in the Netherlands. The early results are encouraging, although the experience is limited. Further registration is necessary to be able to compare the results of laparoscopic cholecystectomy more critically with those of conventional cholecystectomy.     

对阑尾切除术式的一点改进

本文作者从对传统阑尾切除法的5个不足进行介绍,提出了四点具体改进措施.