肠粘连36例腹腔镜松解术应用体会

目的探讨腹腔镜技术治疗术后肠粘连性肠梗阻的临床效果。方法利用腹腔镜松解术治疗术后肠粘连36例,用电凝、分离钳、分离剪及超声刀分离切断粘连带。结果除3例空肠、回肠间紧密广泛粘连、1例外伤性空肠破裂修补术后结肠脾曲肿瘤、1例因阑尾炎术后合并回盲部肿瘤中转开腹手术外,其余均在腹腔镜下行肠粘连松解术,无手术并发症发生。随访3~60个月无症状复发。结论腹腔镜松解术治疗术后肠粘连不仅具有创伤少、恢复快、费用少、痛苦轻、瘢痕小等微创外科的优点,而且再度粘连率低。

Experience in Application of Lysis under Celioscopy to 36 Patients with Intestinal Adhesion

Objective To discuss the clinical effectiveness of cclioscopic technique on postoperative adhesive intestinal obstruction. Methods Thirty-six patients with postoperative intestinal adhesion were treated with lysis under celioscopy. The adhesion was separated by electrocoagulation, ultrasonic scalpel, forceps and scissors. Results All the patients were successfully performed the lysis of intestinal adhesion under celloscopy without postoperative complications, except the three ones who suffered from widely tight adhesion between jejunum and ileum and except the two ones who turned to operation of opening abdomen resulting respectively from complicated colonic tumor after repair for traumatic jejunal rupture and from complicated ileoceeal tumor after operation for appendicitis. The follow-up lasted for 3 - 6 months and there was no symptomatic recurrence during it. Conclusion The lysis under celioscopy for the treatment of postoperative intestinal adhesion has the virtue of httle damage, rapid recovery, low expense, slight pain, small scar, and so on. Furthermore, the rate of reoeated adhesion is low.