妇科腹腔镜手术中转开腹的临床分析
[Clinical analysis of conversion from gynecological laparoscopic surgery to laparotomy].
作者信息
Cheng Jiu-mei, Duan Hua, Wang Jin-juan, Zhang Hong-tao, Liu Yun
机构信息
Department of Center Minimally Invasive Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital University of Medical Sciences, Beijing 100006, China.
出版信息
Zhonghua Fu Chan Ke Za Zhi. 2007 Mar;42(3):173-5.
OBJECTIVE
To discuss the causes and clinical significance of conversion to laparotomy during laparoscopic surgery.
METHOD
Three thousand two hundred and three cases who underwent laparoscopic surgery during the past five years were analyzed retrospectively.
RESULTS
Three thousand one hundred and eighty cases underwent laparoscopic surgery, in which 23 cases were converted to laparotomy due to factors including severe pelvic adhesions (6 cases), complex disease with difficulties in laparoscopy (7 cases), massive haemorrhage (3 cases), bladder trauma (1 case), gastric trauma (1 case), intestinal trauma (1 case), as well as unexpected malignant genitalia neoplasm (4 cases).
CONCLUSION
The major causes for the conversion to laparotomy during gynecology laparoscopic surgery are severe pelvic adhesion and complex disease with difficulties in laparoscopy. Careful evaluation before surgery and conversion to laparotomy at the right moment can decrease the complication.
目的
探讨腹腔镜手术中转开腹的原因及临床意义。
方法
回顾性分析过去五年中行腹腔镜手术的3203例患者。
结果
3180例患者接受了腹腔镜手术，其中23例因严重盆腔粘连（6例）、病情复杂腹腔镜操作困难（7例）、大出血（3例）、膀胱损伤（1例）、胃损伤（1例）、肠损伤（1例）以及意外的生殖器恶性肿瘤（4例）等因素中转开腹。
结论
妇科腹腔镜手术中转开腹的主要原因是严重盆腔粘连和病情复杂腹腔镜操作困难。术前仔细评估并适时中转开腹可减少并发症。
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