[1]茹东跃,陈德兴*①.腹腔镜在小肠不全梗阻手术中的应用[J].中国微创外科杂志,2017,17(4):371-375.
　Ru Dongyue*,Chen Dexing..Application of Laparoscopy for Incomplete Intestinal Obstruction[J].Chinese Journal of Minimally Invasive Surgery,2017,17(4):371-375.
点击复制

腹腔镜在小肠不全梗阻手术中的应用()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年4期
页码:
371-375
栏目:
经验交流
出版日期:
2017-06-30

文章信息/Info

Title:
Application of Laparoscopy for Incomplete Intestinal Obstruction
作者:
茹东跃; 陈德兴*①
吉林省前卫医院普外科，长春130012
Author(s):
Ru Dongyue*;  Chen Dexing.
*Department of General Surgery, Jilin Qianwei Hospital, Changchun 130012, China
关键词:
腹腔镜; 肠梗阻; 肠梗阻导管
Keywords:
Laparoscope; Intestinal obstruction; Ileus tube
文献标志码:
B
摘要:
目的探讨腹腔镜治疗小肠不全梗阻的可行性及临床效果。方法回顾性分析2011年1月~2016年1月85例肠梗阻资料。5例因腹腔束带粘连导致梗阻，腹腔镜下切断束带解除梗阻；75例因小肠与小肠、腹壁、盆腔粘连、成角导致梗阻，腹腔镜下分离粘连、成角解除梗阻；3例探查发现阑尾炎导致梗阻，行阑尾切除术；2例因肠腔异物导致梗阻，腹腔镜下取出异物。腹胀明显者术前留置肠梗阻导管减轻腹胀。结果除2例局部粘连广泛、致密做小切口辅助手术切除部分肠管行端端吻合外，均在腹腔镜下完成，无并发症发生。术后随访3~60个月，平均35个月，未见梗阻症状复发。结论腹腔镜治疗小肠梗阻是可行的，具有切口小、创伤轻、恢复快、术后住院时间短等微创特点，避免开腹手术造成的创伤。
Abstract:
ObjectiveTo explore the feasibility and the clinical effect of laparoscopic treatment of incomplete small intestinal obstruction.MethodsEighty-five patients with intestinal obstruction from January 2011 to January 2016 were analyzed retrospectively. Five cases caused by adhesion band were released by laparoscopic cut of the adhesion band. Seventy-five cases were caused by adhesion between intestine, abdominal wall, and pelvic cavity were given laparoscopic adhesion and angle separation. Laparoscopic exploration found appendicitis in 3 cases and a laparoscopic appendectomy was carried out. Two cases were given laparoscopic removal of foreign body inside the intestine. For patients with obvious abdominal distention, an indwelling ileus tube was placed in the intestine before the operation.ResultsAll the laparoscopic surgeries were successfully performed except 2 patients required an additional small incision to perform partial enterectomy and intestinal anastomosis due to intensive local adhesion. No complications happened. Postoperative follow-ups for 3-60 months (mean, 35 months) found no recurrence.ConclusionsLaparoscopic treatment of small intestinal obstruction is feasible and minimally invasive, having advantages of small incision, rapid recovery and short hospitalization. It avoids the trauma caused by open operation.

参考文献/References:

[1]赵兵，孟塬，龚国杰.腹腔镜下粘连性肠梗阻松懈术28例报告.中国微创外科杂志，2011,11（7）：663-664.
[2]Sallinen V,Wikstrom H,Victorzon M,et al.Laparoscopic versus open adhesiolysis for small bowel obstruction：a multicenter,prospective,randomized,controlled trial.BMC Surg,2014,14:77.
[3]王野，刘志升，孙风波，等.腹腔镜在粪石性小肠梗阻中的应用.中国微创外科杂志,2014,14(12):1144-1146.
[4]O’Connor DB,Winter DC.The role of laparoscopy in the management of acute small-bowel obstruction:a review of over 2,000 cases.Surg Endosc,2012,26(1):12-17.
[5]杜燕夫，渠浩.腹腔镜手术治疗肠梗阻技术难点及对策.中国实用外科杂志，2015，35（5）:496-499.
[6]Kelly KN,Iannuzzi JC,Rickles AS,et al.Laparotomy for small-bowel obstruction:first choice or last resort for adhesiolysis.A laparoscopic approach for small-bowel obstruction reduces 30-day complications.Surg Endosc,2014,28(1):65-73.

备注/Memo

备注/Memo:
*通讯作者，E-mail：jlchendexing@163.com①（长春医学高等专科学校，长春130031）
更新日期/Last Update: 2017-07-14