摘要
目的探讨手助腹腔镜技术在复杂肝脾外科手术的应用价值。方法根据病灶部位和手术要求选择恰当的手助切口,放置手助器和穿刺孔,建立气腹。对172例肝或脾外科疾病进行手助腹腔镜手术,包括肝切除81例,脾切除21例,改良Sugiura术28例,肝脾联合切除4例,肝子宫联合切除1例,肝切除加胆总管取石34术,脾切除加胆总管取石术3例。结果172例手助腹腔镜手术均获得成功,平均手术时间为135 min,平均出血量148 ml,术后无严重并发症发生,术后平均住院日为9.1天。结论只要严格掌握适应症,应用手助腹腔镜技术行复杂肝脾外科手术是安全可行的,有利于减少创伤,降低手术难度,缩短手术时间,有效控制出血。
Objective The study the feasibility and safety of hand-assisted laparoscopic surgery（HALS） in complicated hepatecto-spleen surgery.Methods The handport incision and the first trocar were placed appropriately accoding to lesion＇s location and operative demand.HALS was used in 172 cases including 81 cases of hepatectomy,21 cases of splenectomy,28 cases of modified Sugiura procedure,4 cases of combined hepatectomy with splenectomy,34 cases of combined hepatectomy with choledocholithotomy,one case of combined hepatectomy with total hysterectomy and 3 cases of combined splenectomy with choledocholithotomy.Results HALS were all successful in 172 cases.Mean surgical time was 135 minutes.Mean blood loss was 148 ml.No serious postoperative complications occurred. The mean postoperative hospital stay was 9.12 days.Conclusions HALS is feasible and safe in complicated hepatecto-spleen surgery for strictly selected patients.It offers significant benefits to patients such as reduced operative difficulty and trauma to the abdo minal wall,shortened operative time and applied immediate hemostasis.
出处
《中华腔镜外科杂志（电子版）》
2008年第2期72-75,共4页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
关键词
手助腹腔镜技术
肝切除
脾切除
Hand-assisted laparoscopic surgery
Hepatectomy
Splenectomy
