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腹腔镜在肥胖女性妇科与消化系统疾病联合手术中的应用:一项回顾性队列研究。

Application of laparoscopy in the combined surgical procedures of gynecological and digestive disorders in obese women: a retrospective cohort study.

机构信息

Department of Gynecology, The 260th Hospital of PLA, Shijiazhuang 050041, China.

Department of Gynecology, The 260th Hospital of PLA, Shijiazhuang 050041, China.

出版信息

Int J Surg. 2015 Apr;16(Pt A):83-87. doi: 10.1016/j.ijsu.2015.02.006. Epub 2015 Mar 2.

Abstract

BACKGROUND

Laparoscopy surgery has been widely used for many decades and combined laparoscopic procedures have become favorable choices for concomitant pathologies in the abdomen. However, the type of combination procedures and their safety in obese women have not been well elucidated in obese women.

METHODS

Here we retrospectively reported 147 obese women underwent combined laparoscopic gynecological surgery and cholecystectomy/appendicectomy in our hospital from January 2003 to December 2011. Of the total number of patients (n = 147), various laparoscopic gynecological surgeries were combined with laparoscopic cholecystectomy in 93 patients, and were combined with laparoscopic appendectomy in the rest 54 patients. Patients' ages ranged from 24 to 55 years with an average of 33 years.

RESULTS

Our results showed that combined procedures caused various operative time and blood loss, with no difference considering the time to resume oral intake and length of hospital stay. Intraoperative complications occurred in a total of 7 patients (4.8%). None of the patients suffered from major complications after laparoscopic surgery, and minor postoperative complications occurred in 30 patients (20.4%). The follow-up period ranged from 6 to 24 months (average, 18.5 months). None of the patients developed complications during follow-up, except that one patient suffered from colporrhagia.

CONCLUSIONS

Our results further suggest that the combined abdominal laparoscopic procedures of gynecologic and general surgery are safe and economic choices for obese women, and benefit patients in many ways including lesser pain, shorter hospital stays and earlier recovery.

摘要

背景

腹腔镜手术已经广泛应用了几十年,联合腹腔镜手术已经成为腹部合并疾病的首选方法。然而,肥胖女性中联合手术的类型及其安全性尚未得到充分阐明。

方法

本研究回顾性分析了 2003 年 1 月至 2011 年 12 月期间在我院接受联合腹腔镜妇科手术和胆囊切除术/阑尾切除术的 147 例肥胖女性患者的临床资料。在这 147 例患者中(n=147),93 例患者的各种腹腔镜妇科手术与腹腔镜胆囊切除术联合,其余 54 例患者与腹腔镜阑尾切除术联合。患者年龄 24~55 岁,平均年龄 33 岁。

结果

我们的研究结果表明,联合手术会导致手术时间和出血量的不同,但考虑到恢复口服摄入的时间和住院时间,差异无统计学意义。共有 7 例(4.8%)患者发生术中并发症。所有患者术后均未发生严重并发症,仅有 30 例(20.4%)患者发生轻微术后并发症。随访时间为 6~24 个月(平均 18.5 个月)。除 1 例患者发生阴道穹窿脱垂外,所有患者在随访期间均未发生并发症。

结论

我们的研究结果进一步表明,妇科与普通外科联合腹腔镜手术是肥胖女性安全、经济的选择,在减轻疼痛、缩短住院时间和促进恢复等方面使患者受益。

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