Wang Q, Deng S, Li E
National Endo-Surgery Center of China, Department of Endo-Surgery, Third Teaching Hospital, Beijing Medical University.
Zhonghua Wai Ke Za Zhi. 1997 Feb;35(2):84-8.
With minimal and flexible access, combined laparoscopic surgery (CLS) is most suitable to treat several abdominal diseases simultaneously. Among 1000 cases of laparoscopic procedures since 1991, 52 were CLS. They were laparoscopic cholecystectomy (LC) + appendectomy (LA) 24, LC + laparoscopic fenestration of liver cyst (LFLC) 2, LC + laparoscopic herniorraphy (LH) 4, LC + laparoscopic common bile duct exploration (LCBDE) 12, LC + laparoscopic salpingo-ophorectomy 1, LC + laparoscopic removal of leiomyoma of uterus (LRLU) 1, LC + laparoscopic excision of hemangioleiomyolipoma (LEH) in right kidney 1, LH + laparoscopic varicocelectomy (LV) 2, laparoscopic paraesophageal hernia repair + nissen fundoplication 5. CLS was successfully performed laparoscopically without morbidity and mortality. One case of LC + LCBDE and one case of LH + LNF converted to open surgery be cause of unexpected injury of cystic artery and esophageal rupture. Compared with single laparoscopic surgery, CLS did not increase postoperative pain, hospitalization, recovery period, and cost for equipment and instruments. Our results showed that as long as we insist on basic surgical principles, strictly follow operative indications for CLS, more and more patients with multiple abdominal diseases will enjoy minimal access surgery.
通过微创且灵活的入路，联合腹腔镜手术（CLS）最适合同时治疗多种腹部疾病。自1991年以来的1000例腹腔镜手术中，有52例为CLS。它们包括腹腔镜胆囊切除术（LC）+阑尾切除术（LA）24例、LC+腹腔镜肝囊肿开窗术（LFLC）2例、LC+腹腔镜疝修补术（LH）4例、LC+腹腔镜胆总管探查术（LCBDE）12例、LC+腹腔镜输卵管卵巢切除术1例、LC+腹腔镜子宫肌瘤切除术（LRLU）1例、LC+腹腔镜右肾血管平滑肌脂肪瘤切除术（LEH）1例、LH+腹腔镜精索静脉高位结扎术（LV）2例、腹腔镜食管旁疝修补术+nissen胃底折叠术5例。CLS均成功通过腹腔镜完成，无发病率和死亡率。1例LC+LCBDE和1例LH+LNF因意外的胆囊动脉损伤和食管破裂转为开放手术。与单纯腹腔镜手术相比，CLS并未增加术后疼痛、住院时间、恢复期以及设备和器械成本。我们的结果表明，只要坚持基本的手术原则，严格遵循CLS的手术指征，越来越多患有多种腹部疾病的患者将受益于微创手术。
