腹腔镜结直肠手术的现状与发展

腹腔镜胆囊切除术、抗反流手术及其他良性消化道肿瘤手术已被推荐为“金标准手术”。而腹腔镜手术在根治消化道恶性肿瘤中的应用仍然存在一定争议，1990年美国Jacobs进行了世界上首例腹腔镜右半结肠切除术，同年Folwer进行了腹腔镜乙状结肠切除术，从此腹腔镜技术逐渐运用于传统的结直     

预防腹腔镜胆囊切除术并发症的体会

预防腹腔镜胆囊切除术并发症的体会杜国盛，萧荫祺，许红兵，邹一平，闫恒懦腹腔镜胆囊切除术（ＬＣ）可达到传统开腹切除胆囊的效果具有术后疼痛轻、住院时间短、恢复快等优点，已成为切除胆囊手术的重要方法．随着ＬＣ病例的增多，人们已认识到开膀胆囊切除术所发生的并...     

论腹腔镜结肠直肠手术

腹腔镜胆囊切除术、抗食管反流术及良性消化道肿瘤手术已被推荐为“金标准手术”。而腹腔镜手术在根治消化道恶性肿瘤中的应用则远未达成共识。1991年美国Jacob进行了世界上首例腹腔镜右半结肠切除术,同年Folwer进行了腹腔镜乙状结肠切除术．从此腹腔镜技术逐渐运用于传统的结肠直肠手术,但发展速度远不如其他腹腔镜手术。     

腹腔镜胆囊切除术中复杂问题的处理对策（附2500例报告）

腹腔镜胆囊切除术(LC)已广泛开展，并被认可和接受，它的“微创”治疗意义远远超过传统的外科手术，其优越性是多方面的。但LC不能完全代替开腹胆囊切除术(OC)，因此正确处理LC中遇到的难题，如何提高手术的安全性和降低并发症的发生率，一直是腹腔镜外科医师讨论的重点，笔者回顾分析了2500例腹腔镜胆囊切除术，对术中的疑难问题做一讨论。     

腹腔镜胆囊切除术并发症的面面观

腹腔镜胆囊切除术并发症的面面观刘国礼腹腔镜胆囊切除术在我国已开展五年多，从总体看它已走过童年时代，步入成熟时期。手术并发症明显减少，治疗效果明显提高，腹腔镜胆囊切除术的优点已被人们承认和接受，越来越明显地受到病人的欢迎。在我国已进入普及阶段，出现了腹...     

腹腔镜下胆囊切除术120例

随着微创技术的不断发展，腹腔镜手术已广泛应用于临床并取得较好疗效[1]。腹腔镜下胆囊切除手术是临床治疗胆道疾病的重要手法之一，随着腹腔镜手术的临床应用．三孔腹腔镜逐渐替代传统四孔法拉[2]，选取我院120例患者行对比研究，探讨三孔法腹腔镜下胆囊切除术治疗胆道疾病的方法及临床效果．总结报道如下。     

必须重视腹腔镜胆囊切除术的安全性

必须重视腹腔镜胆囊切除术的安全性黄志强胆囊切除术是当前腹部外科中最常做的手术之一。腹腔镜胆囊切除术在我国自１９９２年首次应用于临床之后，发展迅速，在不少医院，它已应用于９０％以上的胆囊切除术患者，，总的效果是好的，然而也出现一些严重的并发症，包括腹腔...     

传统开腹、腹腔镜与小切口胆囊切除术的对比研究

目的 分析传统开腹、腹腔镜及小切口胆囊切除术三者在治疗胆囊结石中手术疗效.方法 收集89例胆囊切除术患者资料,根据不同手术方法分为3组:传统开腹胆囊切除术(OC组,29例)、腹腔镜胆囊切除术(LC组,30例)及小切口胆囊切除术(MC组,29例),分析三类不同方法手术的优缺点.结果 LC组和MC组的出血量、消化功能恢复时...     

腹腔镜胆囊切除术165例临床体会

腹腔镜胆囊切除术（laparoscopic cholecystectomy，LC）是治疗胆囊良性疾病安全有效的方法，目前已取代传统开腹手术成为胆囊切除术的金标准。2006年7月至2008年12月我院共实施LC165例，效果良好，现报道如下。     

腹腔镜胆囊切除术与经腹胆囊切除术疗效比较

腹腔镜胆囊切除术与经腹胆囊切除术疗效比较程建华，吕建一，陈忠目前传统的经腹胆囊切除术（Ｃｏｎｖｅｎ－ｔｉｏｎａｌＣｈｏｌｅｃｙｓｔｅｃｔｏｍｙ，ＣＣ）和腹腔镜胆囊切除术（ＬａｐａｒｏｓｃｏｐｉｃＣｈｏｌｅｃｙｓｔｅｃｔｏｍｙ，ＬＣ）已成为症状性结石性...     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.