腹腔镜手术在直肠癌局部复发治疗中的应用

目的探讨应用腹腔镜手术治疗直肠癌局部复发的可行性。方法 2006年1月至2009年6月对收治的11例直肠癌术后复发患者施行腹腔镜手术,男7例,女4例,平均年龄(55.1±9.9)岁。其中3例为开腹Dixon术后复发,6例为腹腔镜Dixon术后复发,2例为腹腔镜Miles术后复发。平均复发间隔(24.9±11.0)个月。结果本组11例患者手术均获成功,平均手术时间(212±42)min,术中出血量(133±75)ml,住院时间(13.5±7.6)d。无腹腔出血、吻合口漏等严重并发症发生,无围手术期死亡病例,2例中转开腹手术。9例行Dixon术后复发的患者中,1例再次行腹腔镜下Dixon术;4例行腹腔镜下腹会阴联合切除术;1例行腹腔镜下后盆腔脏器联合切除术;1例行腹腔镜下双侧附件切除术;1例行腹腔镜乙状结肠造口术;1例中转开腹行乙状结肠造口术。2例行腹腔镜Miles术后复发的患者,1例行腹腔镜下盆腔肿块切除术,1例因肠管粘连中转开腹行盆腔肿块切除术。结论选择合适的直肠癌术后复发病例施行腹腔镜再手术是安全可行的。     

腹腔镜与开腹手术治疗卵巢良性肿瘤2141例临床分析

目的探讨腹腔镜手术治疗卵巢良性肿瘤的临床价值。方法回顾分析2010年1月～2011年9月2141例行腹腔镜（770例）或开腹（1371例）手术治疗的卵巢良性肿瘤患者的临床资料,其中384例行患侧附件切除,1757例行肿瘤剔除。比较两组围手术期情况及住院费用。结果术后病理诊断为卵巢良性畸胎瘤899例,卵巢单纯性囊肿124例,卵巢囊腺瘤1070例,卵巢纤维瘤48例。与开腹组相比,腹腔镜组患者年轻[（32.7±9.4）岁vs.（39.7±13.8）岁,t=-12.499,P=0.000],肿瘤小[（6.03±1.85）cm vs.（6.83±2.37）cm,t=-8.085,P=0.000]。腹腔镜组手术时间早[（61.5±8.5）min vs.（72.5±7.1）min,t=-32.084,P=0.000],术中出血少[（75.0±10.5）ml vs.（105.5±9.0）ml,t=-70.796,P=0.000],术后排气早[（10.5±4.1）h vs.（33.0±9.6）h,t=-62.046,P=0.000],下床活动早[（12.5±1.8）h vs.（36.7±10.9）h,t=-61.010,P=0.000],术后住院时间短[（4.7±1.2）d vs.（8.9±2.3）d,t=-46.904,P=0.000];但住院费用高[（15 172±2876）元vs.（11 576±2851）元,t=27.919,P=0.000]。结论对卵巢良性肿瘤实施腹腔镜手术较之开腹手术治疗,手术出血少,术后恢复快,有较大的应用价值,值得推广。     

腹腔镜手术治疗盆腔包裹性积液99例分析

目的探讨腹腔镜手术治疗盆腔包裹性积液的的可行性和安全性。方法2009年1月~2018年4月我科99例术前盆腔肿物性质不明,术后病理诊断为盆腔包裹性积液。年龄<40岁、有生育需求者行腹腔镜患侧附件囊肿剥除术;绝经期、年龄>45岁且无生育需求者行腹腔镜患侧附件切除术;年龄40~45岁,根据既往手术史、有无生育需求并结合患者个人意愿决定行腹腔镜患侧附件囊肿剥除术或患侧附件切除。结果98例完成腹腔镜手术,1例因粘连严重中转开腹。术中见99例均存在粘连,其中重度粘连(mAFS评分5~6分)76例。行患侧囊肿剥除术69例,患侧附件切除术30例,同时行粘连松解术。手术时间19~285 min,中位数88 min。术中出血量5~200 ml,中位数25 ml。截止2019年3月,随访78例,其中30例随访不足1年,48例随访1~10年(中位随访时间3.5年),6例(12.5%)超声检查示再发盆腔包块(复发时间术后2个月~5年,中位数20个月),其中2例出现下腹痛等症状,其余均为无症状复发。结论腹腔镜手术治疗盆腔包裹性积液安全、可行。     

腹腔镜在妇科急症中的应用

目的:探讨腹腔镜在妇科急症中的应用价值。方法:2002年以来,应用腹腔镜行妇科急症手术85例,其中异位妊娠62例中行患侧输卵管切除术36例,输卵管切开取胚术及病灶清除术23例,1例卵巢妊娠行卵巢部分切除术,输卵管病灶注药术2例;卵巢破裂10例,9例行电凝止血术,1例行患侧附件切除术;卵巢肿瘤蒂扭转6例,2例不全扭转行囊肿剥除术,4例完全扭转附件坏死行一侧附件切除术;急性盆腔炎7例,行脓肿清除、输卵管切除及盆腔粘连松解术。结果:85例急诊腹腔镜手术全部顺利完成,无一例并发症。结论:腹腔镜治疗妇科急症安全有效,较开腹手术有很多优越性。     

非气腹腹腔镜手术治疗妊娠合并卵巢良性肿瘤45例

目的：探讨非气腹腹腔镜手术治疗妊娠合并卵巢良性肿瘤的可行性。方法2006年1月～2013年6月对45例妊娠合并卵巢良性肿瘤行非气腹腹腔镜手术,硬膜外阻滞麻醉下按照非气腹腹腔镜手术常规操作,一般行肿瘤剥除术,肿瘤巨大、缺乏或剩余极少正常卵巢组织或已扭转坏死行患侧附件切除术。结果45例均顺利完成非气腹腹腔镜手术,无中转开腹和并发症发生。42例行卵巢肿瘤剥除术,3例行患侧附件切除术。手术时间25～90 min,（40．7±14．9） min;术中出血量10～80 ml,（27．3±16．6）ml;住院时间3～8 d,（4．5±1．3）d。术前、术中、术后动脉血pH值、二氧化碳分压（blood pressure carbon dioxide, PaCO2）、氧分压（blood oxygen partial pressure,PaO2）均无统计学差异（F＝0．00,P＝0．999;F＝2．21, P＝0．114;F＝0．60,P＝0．555）,碳酸氢根（bicarbonate,HCO3-）和血氧饱和度（blood oxygen saturation,SpO2）虽有统计学差异（F＝14．96,P＝0．000;F＝9．45,P＝0．000）,但无临床意义,均在正常范围内。术前、术中、术后监测胎心率均在正常范围内。术前、术中、术后心率和血压比较无统计学差异（P＞0．05）。术后病理：成熟性囊性畸胎瘤25例（55．6％）,浆液性囊腺瘤6例（13．3％）,黏液性囊腺瘤4例（8．9％）,输卵管系膜囊肿3例（6．7％）,子宫内膜异位囊肿2例（4．4％）,黄体囊肿5例（11．1％）。术后随访无自然流产,43例妊娠至足月分娩,新生儿出生体重和Apgar评分未见异常,2例术后要求放弃胎儿。结论非气腹腹腔镜手术治疗妊娠合并卵巢良性肿瘤期是安全可行的。     

腹腔镜与开腹手术治疗中期妊娠卵巢肿瘤的比较

目的探讨腹腔镜手术治疗中期妊娠卵巢肿瘤的可行性和安全性。方法2006年1月～2011年1月我院32例中期妊娠合并卵巢肿瘤分别行全麻下腹腔镜手术（腹腔镜组,n=14）和开腹手术（开腹组,n=18）。腹腔镜手术一般距离宫底或肿瘤上缘（以大者为准）至少3横指处做第一切口,余切口随之改变,气腹形成后,监测生命体征及氧饱和度直至手术结束后1h。卵巢肿瘤剥除术：用剪刀切开肿瘤包膜,将肿瘤完整剥出装袋取出,若肿瘤直径〉8cm,穿刺抽吸囊液后剥除肿瘤。患侧附件切除术：提起附件边凝边切,取出同卵巢肿瘤剥除术。结果腹腔镜组肿瘤剥除术10例,附件切除术4例,无一例中转开腹。开腹组肿瘤剥除术13例,附件切除术5例。腹腔镜组手术时间（73．9±26．8）min与开腹组（72．8±22．2）min比较无统计学差异（t=0．127,P=0．900）。腹腔镜组术中出血量（56．4±25．9）ml与开腹组（48．9±22．5）ml比较无统计学差异（t=0．876,P=0．388）。腹腔镜术后住院（5．0±0．8）d,显著短于开腹组（8．7±2．8）d（t=-4．779,P=0．000）。术后病理：腹腔镜组成熟性畸胎瘤12例,黏液性囊腺瘤2例;开腹组成熟性畸胎瘤5例,黏液性囊腺瘤10例,浆液黏液混合性囊腺瘤2例,交界性乳头状囊腺瘤1例。卵巢肿瘤蒂扭转9例,其中成熟性畸胎瘤8例,黏液性囊腺瘤（伴囊壁钙化）1例。患者术后均无并发症,随访至分娩,腹腔镜组新生儿Apgar评分（9．8±0．4）分与开腹组（9．7±0．5）分比较无统计学差异（t=0．584,P=0．564）;新生儿出生体重（3357．7±471．2）g与开腹组（3421．9±155．9）g比较无统计学差异（t=-0．513,P=0．612）;新生儿出生孕周（38．5±1．3）周与开腹组（39．1±0．9）周比较无统计学差异（t=-1．466,P=0．154）;早产率与开腹组无统计学差异[7．7％（1／13） vs．0,P=0．448]。结论腹腔镜手术治疗中期妊娠卵巢肿瘤是安全可行的。     

脾占位性病变的诊断治疗：附68例报告

目的:探讨脾肿瘤的临床特点和诊治方法。方法:回顾性分析68例经手术及病理证实为脾肿瘤的临床资料。结果:良性脾占位性病变31例（45.59%），包括脾囊肿15例，血管瘤12例，淋巴管瘤3例，脾脓肿1例。恶性37例（54.41%），包括转移癌24例，血管肉瘤1例，恶性纤维组织细胞瘤1例，淋巴瘤11例。术前B超诊断为占位性病变者57例（83.82%），CT诊断为占位性病变者62例（91.18%）。59例行脾切除，6例行脾部分切除术，2例行脾囊肿穿刺引流术，1例行穿刺活检术。良性肿瘤22例获13~114个月随访，均生存良好。恶性肿瘤23例获12~79个月随访，8例淋巴瘤生存时间为14~79个月，中位生存时间33个月，其他恶性肿瘤15例中，仅3例生存＞2年，其余均在3~12个月内死亡。结论:B超和CT检查是脾肿瘤的主要诊断手段，治疗上应以手术治疗为主。良性肿瘤无论行脾切除术或脾部分切除术，术后均无需特殊处理；恶性肿瘤应以手术为主，恶性淋巴瘤在脾切除术基础上行辅助化疗对延长生存期有意义，对转移癌患者尚需在术后行相应的辅助性治疗。     

经脐单孔腹腔镜手术治疗巨大附件良性肿瘤30例

目的探讨经脐单孔腹腔镜手术治疗巨大附件良性肿瘤可行性和安全性。方法 2017年10月～2018年11月同一术者对30例巨大附件良性肿瘤实施单孔腹腔镜手术,采用经脐入路,1. 5～2. 0 cm切口置入切口保护套及Port,用相关腹腔镜器械完成经脐单孔腹腔镜手术,手术方式包括卵巢囊肿剔除术、附件切除术、全子宫+单附件或双附件切除术。结果 30例均成功完成经脐单孔腹腔镜手术,无一例增加辅助穿刺孔或中转开腹,其中卵巢囊肿剔除术8例,单/双附件切除13例,全子宫+单附件或双附件切除9例。术中囊肿破裂2例(6. 7%)。无一例术中、术后并发症。术后病理均良性肿瘤,无一例交界瘤或恶性肿瘤,其中浆液性囊腺瘤9例,成熟囊性畸胎瘤8例,黏液性囊腺瘤7例,纤维瘤、子宫内膜异位囊肿、单纯囊肿各2例。术后住院时间中位数4 d(1～10 d)。30例中位随访时间6. 5月(1～12个月),无一例复发。结论经脐腹腔镜手术治疗巨大附件良性肿瘤安全、可行。     

腹腔镜下卵巢子宫内膜异位囊肿剔除术88例分析

目的探讨腹腔镜下卵巢子宫内膜异位囊肿剔除术的临床疗效。方法对2008年1月至2011年8月,本院88例患者行腹腔镜下卵巢子宫内膜异位囊肿剔除术,并术后给予药物治疗。结果 88例均在腹腔镜下完成,无中转开腹和并发症发生。其中,单侧囊肿剔除69例,双侧囊肿剔除15例,一侧囊肿剔除加另侧附件切除4例。行盆腔粘连松解术74例,盆腔子宫内膜异位结节烧灼术65例,输卵管通液术11例,输卵管造口术2例。88例术后随访81例,随访率92.05%。不孕组妊娠5例,妊娠率45.45%。术后复发6例,复发率7.81%。结论腹腔镜下卵巢子宫内膜异位囊肿剔除术是安全、有效的手术方法。     

腹腔镜阑尾切除术后再手术原因分析

目的 分析腹腔镜阑尾炎手术后再手术的原因,探讨腹腔镜阑尾炎手术中应注意的事项.方法 2003年5月~2013年3月,发生11例腹腔镜阑尾切除术后再手术.急性阑尾炎10例,慢性阑尾炎1例.再手术原因：腹腔脓肿4例,回盲部肿瘤1例,腹腔大出血并休克1例,腹膜后血肿1例,小肠漏1例,肠粘连1例,盆腔炎1例,胰腺炎1例.经保守治疗无效,8例行腹腔镜探查,3例开腹探查.结果 二次手术均成功.腹腔脓肿4例行腹腔镜脓肿清洗引流,腹腔大出血并休克1例行腹腔镜探查腹壁下动脉结扎,肠粘连1例行腹腔镜探查粘连带松解,盆腔炎1例行腹腔镜盆腔冲洗引流＋抗感染治疗,胰腺炎1例行腹腔镜胰腺被膜打开胰腺周围置管引流;小肠漏1例行腹腔镜探查＋开腹小肠肠管部分切除吻合术,腹膜后血肿1例行开腹探查阑尾动脉结扎,回盲部肿瘤1例行开腹右半结肠切除术（病理高分化腺癌）.术后7~21天痊愈出院.结论 腹腔镜下阑尾切除术后再手术的原因为：术前术中漏诊、误诊;术中脓液清洗不彻底,术后引流不通畅致腹腔脓肿形成;术中操作不规范,致腹壁下血管、阑尾动脉出血.腹腔镜阑尾切除术应注意规范操作,术中应探查仔细,防止漏诊、误诊.     

单孔腹腔镜手术探查并诊治子宫切除术后盆腔包块53例临床分析

目的:总结单孔腹腔镜手术诊治子宫切除术后盆腔包块的应用价值及手术方法。方法:回顾分析5年间采用单孔腹腔镜手术诊治53例子宫切除术后盆腔包块患者的临床资料。结果:53例中10例患者行术中冰冻;38例患者获得标本,行常规病理检查。结合探查及病理47例诊断为卵巢瘤样病变,5例为卵巢良性肿瘤(1例畸胎瘤,2例浆液性囊腺瘤,2例粘液性囊腺瘤),1例为恶性肿瘤。41例直接行单孔腹腔镜手术,11例因腹腔粘连严重中转三孔法腹腔镜手术,1例恶性肿瘤患者中转开腹。结论:单孔腹腔镜探查术对子宫切除术后盆腔包块的诊治具有较高的临床应用价值。     

Laparoscopic appendectomy: a gynecological approach

The removal of surgical specimen at operative laparoscopy through an incision of the posterior fornix is frequently performed for the removal of pelvic masses of the internal genital tract. We present a technique for the removal of the appendix through a laparoscopic colpotomy. Eight patients who underwent laparoscopy for a suspected pelvic or adnexal disease and intraoperatively found to be affected by an appendicular disease were included in the present series. After intrabdominal dissection, the appendix was removed from the abdomen transvaginally through a laparoscopic colpotomy. The median range of the operation was 45 minutes (range 25-95). There were no intraoperative complications. The postoperative hospitalization period ranged from 2 to 7 days. Vaginal spotting was present in one case and lasted 24 hours. At follow-up visit, no patients complained of pelvic pain or dyspareunia. Vaginal wall induration was not found in any of the patients at pelvic examination. The removal of the appendix through a posterior colpotomy after laparoscopic appendectomy is simple, safe, feasible, well tolerated, and can be considered a valid alternative to other methods.     

Alternate methods for laparoscopic management of adnexal masses greater than 10 cm in diameter.

PURPOSE: We describe alternate laparoscopic methods for inspection and removal of large adnexal masses, and report our experience with 18 cases in which these methods were used. PATIENTS AND METHODS: Between April 1994 and January 2000, the first author performed operative laparoscopy on 18 patients, each of whom had at least one adnexal mass with maximum diameter greater than 10 cm. Mean patient age was 32 years (range 11 to 82). Seventeen of the 18 patients were premenopausal. All procedures were performed at one of two community hospitals in Seattle or at Yuan's General Hospital in Taiwan. Preoperative screening included pelvic exam, tumor markers, and ultrasound. RESULTS: One 82-year-old patient underwent planned laparoscopic bilateral oopherectomy. In the other 17 cases the operative goal was cystectomy or unilateral oopherectomy with conservation of reproductive function. Cystectomy was successfully performed in five of these cases (29.4%). The remaining 12 patients underwent either unilateral oopherectomy (10 cases, 58.8%), or unilateral salpingo oopherectomy (2 cases, 8.8%) due to the extent of their mass. Sixteen of the 18 cases in this series were successfully managed by a single laparoscopic surgery, one case required a second-look laparoscopy, and in one case a malignancy was found by histological analysis of permanent section, which required a second laparoscopy for staging and debulking. CONCLUSIONS: Large adnexal masses can be successfully managed with minimal hospital stay using laparoscopic techniques, when care is taken to avoid rupture and spillage of cyst contents, and thorough inspection of the mass and abdominal cavity is made possible. The probability of finding an unexpected malignancy is low. In those cases where a malignancy is found, appropriate cytoreductive staging surgery can be performed immediately.     

Laparoscopy or laparotomy for the management of endometrial cancer.

OBJECTIVE: The aim of this study was to evaluate the feasibility of laparoscopy in the management of early stage endometrial cancer. METHODS: Fifty-two patients with endometrial cancer who underwent surgical staging consisting of total hysterectomy, bilateral salpingo-oophorectomy with pelvic lymph node dissection, and cytology between 1998 to 2002 were included in the study. Laparotomy and laparoscopy were randomly offered to patients upon admittance. RESULTS: Of 52 patients, 26 underwent laparotomy and the remaining 26 underwent laparoscopic staging surgery. No significant difference existed between the demographic characteristics of the 2 groups. The mean number of harvested lymph nodes was 18.2 in the laparoscopic group and 21.1 in the laparotomic group (P>0.05). Pelvic lymph node metastases were detected in 7.7% of the patients in the laparoscopy group and 15.4% in the laparotomy group, and the difference was not significant. Adjuvant radiotherapy was applied later to 42.3% of the laparoscopy group and 38.5% of the laparotomy group. Operative morbidity was higher in the laparotomy group mainly because of postoperative wound infection, and the patients in the laparotomy group had a longer hospital stay. CONCLUSION: Laparoscopic surgery is a method that can be applied as well as laparotomy in the management of endometrial cancer. Lymph node number and detection of lymph node metastasis did not differ significantly in laparotomic and laparoscopic approaches. Wound infections were more frequent in laparotomies.     

Assessment of risk for intra-abdominal adhesions at laparoscopy for urological tumors

PURPOSE: Abdominal wall adhesions at laparoscopy may predispose patients to access related injuries and increase the complexity of the procedure. We have observed concern from referring physicians regarding the safety of laparoscopy in patients who previously underwent surgery because of the risk of abdominal adhesions. To assess the risk of adhesions at laparoscopy a retrospective cohort study was performed. MATERIALS AND METHODS: All patients who underwent a transperitoneal urological laparoscopic procedure in a 6-year period at our institution were included in this study. A chart review was performed to obtain demographic/surgical data and identify preoperative risk factors for adhesions, such as previous abdominal or pelvic surgery, radiation and/or intra-abdominal inflammatory disease. Operative videotapes were reviewed to determine the presence and location of adhesions. Standard statistical analyses were performed. RESULTS: During the study period 127 patients underwent transperitoneal laparoscopy and videotapes on 82 (65%) were available for review. A total of 44 patients (54%) were identified with preoperative risk factors for adhesions (group 1), while 38 (46%) had no risk factors (group 2). The relative risk of adhesions was 1.34 (95% CI 0.89 to 2.01, p = 0.18) when risk factors were identified. There were no differences in the groups in patient age, operative time, access technique, conversion to open surgery or complications. Estimated blood loss was significantly higher in group 2, likely due to the preponderance of cytoreductive laparoscopic nephrectomy in this group. CONCLUSIONS: There was no difference in the risk of intra-abdominal adhesions in patients with and without identifiable preoperative risk factors. Preoperative risk factors for adhesions should not contraindicate the transperitoneal laparoscopic approach for urological oncology procedures.     

Laparoscopic hysteropexy in a patient with spina bifida and ventriculoperitoneal shunt

Laparoscopic repair of pelvic organ prolapse in patients with ventriculoperitoneal shunts has not been previously described. The optimum management of patients with ventriculoperitoneal shunts undergoing laparoscopy is uncertain. We describe the case of a 21-year-old female patient with spina bifida and ventriculoperitoneal shunt who underwent laparoscopic hysteropexy for severe pelvic organ prolapse. The implications of performing laparoscopy on patients with ventriculoperitoneal shunts are reviewed along with strategies to reduce potential intraoperative complications.     

Impact of diagnostic laparoscopy on the management of chronic pelvic pain

Background Diagnostic laparoscopy is a useful tool, especially when there is no definite anatomical abnormality visible on imaging modalities. We assess the role and clinical impact of diagnostic laparoscopy in the management of women with chronic pelvic pain. Methods Clinical data of 3,068 cases of diagnostic laparoscopy performed for chronic pelvic pain from June 1994 to August 2005 were analyzed. We compared the diagnoses after diagnostic laparoscopy and those after pelvic examination and imaging modalities such as ultrasound or computed tomography (CT), and we then checked the final pathologic diagnoses after operation. Results Pelvic endometriosis was the most common (60.2%) laparoscopic finding in patients with chronic pelvic pain in this study, followed by normal pelvic findings (21.2%) and pelvic congestion (13.0%). Diagnostic laparoscopy had an influence on correcting previous plans based on imaging modalities in 42.7% of patients such as discarding unnecessary procedures or introducing new diagnostic or therapeutic plans. There were 3 cases of major complications requiring immediate correction. Conclusions Diagnostic laparoscopy is a useful diagnostic tool for of women with chronic pelvic pain and can be used as a guideline for individualized treatment.     

腹腔镜下输卵管盆腔病变分期对不孕症预后的影响分析

目的：探讨腹腔镜下输卵管盆腔病变分期对不孕症患者预后的影响。方法：回顾分析2009年4月至2010年8月为80例输卵管远端梗阻性不孕患者行腹腔镜再通术的临床资料,并总结术后随访情况。结果：80例患者术后宫内总妊娠率为27．50％（22／80）。输卵管盆腔病变分为Ⅰ、Ⅱ、Ⅲ、Ⅳ期,术后1年宫内妊娠率分别为61．11％、38．10％、11．54％及O：输卵管病变Ⅰ-Ⅱ期的患者,术后宫内妊娠率明显高于Ⅲ-Ⅳ期的患者。结论：对于输卵管远端梗阻性不孕症的患者,腹腔镜是首选检查方式。腹腔镜手术可准确评估输卵管病变情况及盆腔粘连程度,并同时予以相应治疗。术后可根据术中输卵管盆腔病变分期情况指导患者选择助孕方式。     

Laparoscopic Appendectomy in Women Without Identifiable Pathology Undergoing Laparoscopy for Chronic Pelvic Pain

Objectives:

To assess the effectiveness of appendectomy in women undergoing laparoscopy for chronic pelvic pain without identifiable pathology.

Methods:

This retrospective cohort study included women aged 15 to 50 years who underwent laparoscopic surgery for chronic pelvic pain without identifiable pathology. The cohort was divided into 2 groups: women who underwent appendectomy and women who had not undergone appendectomy at laparoscopic surgery. Postoperative pain was assessed at 6-week follow-up and by subsequent mailed questionnaire.

Results:

Women who underwent appendectomy (n = 19) were significantly more likely to report improvement in pain at 6-week follow-up than women who did not undergo appendectomy (n = 76) (93% vs 16%; P < .001). Thirty-six patients (38%) responded to the questionnaire at a median of 4.2 years after surgery, when the median change (improvement) in reported pain was greater in the appendectomy group than in the nonappendectomy group.

Conclusion:

Appendectomy is effective therapy for patients with chronic pelvic pain of unknown etiology who are undergoing laparoscopy.     

腹腔镜诊治盆腔开放性手术史附件包块患者的临床分析

目的:探讨为有盆腔开放性手术史的附件包块患者行腹腔镜手术的安全性和可行性.方法:2005年1月至2009年12月腹腔镜手术诊治附件包块患者共765例,随机抽取有盆腔开腹手术史112例作为研究组,无盆腔手术史的125例为对照组,对比分析两组患者手术情况,结果:两组在手术成功率、术中出血量、术后胃肠功能恢复时间、住院时间等...