术中内镜在胃肠手术中的应用价值

目的：探讨术中内镜在胃肠手术中的应用价值。方法：对32例胃肠手术的患者进行了术中内镜检查，其中25例为剖腹探查，7例为术前明确诊断但术中找不到病灶或难以确定病灶的边缘者。结果：25例剖腹探查术患者24例通过术中内镜明确了诊断，分别为：胃底Dieulafoy病1例，胃溃疡1例，十二指肠平滑肌瘤3例，小肠平滑肉瘤2例，十二指肠水平部Dieulafoy病1例，十二指肠水平部平滑肌瘤2例，回肠淋巴瘤2例，小肠腺瘤性息肉2例，加肠末段溃疡2例，小肠海绵状血管瘤3例，小肠动静脉畸形4例，胰空肠吻合口出血1例。所有32例患者除1例小肠息肉和1例结肠息肉予内镜下高频电切除术、1例未找到病灶而未予特别处理外，其余28例患者均进行了病变切除。结论：应用术中内镜不仅极大地提高了病变的检出率，而且能对病变准确定位。术中内镜诊疗术是安全且有效的。

Evaluating the Value of Intraoperative Endoscopy in the Operation of the Gastrointestinal Tract

Objective: To evaluate the application of intraoperative endoscopy in the operation of the gastrointestinal tract. Methods:32 patients (22 males, 10 females), age ranged 12 to 78 years old, were performed intraoperative endoscopy. Of the 32 patients,25 received exploratory laparotomy, 7 undergone operation of gastrointestinal tract but operator cannot find the lesion or cannot determine the edge of the lesion, although 7 patients diagnosis was clear before the operation. Among 25 patients received exploratory laparotomy, intraoperative endoscopy disclosed the lesions in 24: Dieulafoy' disease of fundus of stomach 1,gastric ulcer 1 .duodenal leiomyoma 2,duodenal Dieualfoy' disease 1,small bowel leiomyoma 3, small bowel leiomyosarcoma 2,ileum lymphoma 2, small bowel polyp 2, ileum ulcer 2, small bowel cavernous hemangioma 3, small bowel arteriovenous dysmorphosis 4, pancreaticojejunostomy cut bleeding 1. Endoscopic polypectomy using high frequency coagulation and cutting was done in 1 patient with small bowel polyp and 1 patient with colonic polyp, ligation was don in 1 patient with pancreatieojcjunostomy cut bleeding, partial gastrointestinal tract resections were done in 28 patients with other gastrointestinal diseases , no special surgical treatment was done in 1 patient with gastrointestinal bleeding because nothing was found in whom with intraoperative endoscopy. Conclusion: Results revealed that intraoperative endoscopy is a useful and safe tool for the laparotomy because of the gastrointestinal tract disease or the localization of pathologies and the edge determination of the lesions.