[腹腔镜粘连松解术——前瞻性监测结果]

[Laparoscopic adhesiolysis - results following prospective surveillance].

作者信息

Schenk C, Scheuerecker H, Glaser F

机构信息

Abteilung für Chirurgie (Leitender Arzt: Priv.-Doz. Dr. F. Glaser), Filderklinik, Filderstadt.

出版信息

Chirurg. 2000 Jan;71(1):66-71.

PMID:10663005

Abstract

INTRODUCTION

About 90 % of the patients have abdominal surgery develop adhesions afterward. Studies analyzing complications and follow-up even in emergency cases are rare.

METHODS

Intra- and postoperative findings and complications and follow-up were analyzed in a prospective trial between January 1994 and June 1998.

RESULTS

We performed laparoscopic procedures in 56 patients with complaints of obstructing adhesive bands or adhesions. Ninety-six percent of the patients have had abdominal surgery; 51.8 % were treated as emergency cases with acute pain, 48.2 % with chronic abdominal pain. Intraoperatively, 37.5 % of the patients showed single adhesive bands; 62.5 % showed adhesions. Mean operation time was 60 min, conversion rate: 5.4 %. Complications were recorded according to the "Cologne classification": class I: 78.6 %, class II: 8.9 %, class III: 1.8 %, class IV: 10.8 %, class V: 0 %. The postoperative hospital stay was 6 days on average.

CONCLUSION

Our study suggests that laparoscopic adhesiolysis can be done safely in emergency cases and in patients with extensive adhesions as well.

摘要

引言

约90%接受腹部手术的患者术后会形成粘连。即便在急诊病例中，对并发症及随访情况进行分析的研究也很罕见。

方法

对1994年1月至1998年6月间一项前瞻性试验中的术中、术后发现、并发症及随访情况进行分析。

结果

我们对56例因粘连性束带或粘连引起梗阻而就诊的患者实施了腹腔镜手术。96%的患者曾接受过腹部手术；51.8%作为急诊病例接受治疗，伴有急性疼痛，48.2%伴有慢性腹痛。术中，37.5%的患者显示为单一粘连性束带；62.5%显示为粘连。平均手术时间为60分钟，中转率为5.4%。根据“科隆分类法”记录并发症：I类：78.6%，II类：8.9%，III类：1.8%，IV类：10.8%，V类：0%。术后平均住院时间为6天。