Agrusa A, Romano G, Di Buono G, Dafnomili A, Gulotta G
Department of General Surgery, University Hospital P. Giaccone, Palermo, Italy.
G Chir. 2012 Nov-Dec;33(11-12):400-3.
Laparoscopy is ever more common in both elective and emergency surgery. In fact, in abdominal emergencies it enables the resolution of preoperative diagnostic doubts as well as treatment of the underlying disease. We present a retrospective study of the results of a 5-year experience at a single center.
Between September 2006 and August 2011, 961 patients were treated via laparoscopy, including 486 emergency cases (15 gastroduodenal perforation; 165 acute cholecystitis; 255 acute appendicitis; 15 pelvic inflammatory disease and non-specific abdominal pain [NSAP]; 36 small bowel obstruction). All procedures were conducted by a team trained in laparoscopic surgery.
The conversion rate was 22/486 patients (4.53%). A definitive laparoscopic diagnosis was possible in over 96% of cases, and definitive treatment via laparoscopy was possible in most of these.
Our own experience confirms the literature evidence that laparoscopy is a valid option in the surgical treatment of abdominal emergencies. In any case, it must be performed by a dedicated and highly experienced team. Correct patient selection is also important, to enable the most suitable approach for each given situation.
腹腔镜检查在择期手术和急诊手术中都越来越常见。事实上,在腹部急诊中,它能够解决术前诊断疑问并治疗潜在疾病。我们对单一中心5年的经验结果进行了一项回顾性研究。
2006年9月至2011年8月期间,961例患者接受了腹腔镜检查,其中包括486例急诊病例(15例胃十二指肠穿孔;165例急性胆囊炎;255例急性阑尾炎;15例盆腔炎和非特异性腹痛[NSAP];36例小肠梗阻)。所有手术均由经过腹腔镜手术培训的团队进行。
486例患者中有22例(4.53%)中转开腹。超过96%的病例能够通过腹腔镜做出明确诊断,并且其中大多数病例能够通过腹腔镜进行明确治疗。
我们自己的经验证实了文献证据,即腹腔镜检查是腹部急诊手术治疗中的一种有效选择。无论如何,必须由专业且经验丰富的团队进行。正确选择患者也很重要,以便针对每种特定情况采用最合适的方法。