Croce E, Azzola M, Russo R, Golia M, Angelini S, Olmi S
Center for Minimally Invasive Surgery, Ospedale Fatebenefratelli ed Oftalmico, Milan, Italy.
Endosc Surg Allied Technol. 1994 Jun-Aug;2(3-4):186-8.
Our initial experience with four minor resections for one malignant and three benign lesions is reported. Dissection was accomplished by mechanical fragmentation and hydrojet. Coagulation was effectively achieved by the argon beam system. Larger vessels were clipped. Three patients were treated laparoscopically and were rapidly discharged after an uneventful postoperative course. The other patient (small hepatocellular carcinoma in cirrhotic liver) had an intraoperative cardiac arrest, probably due to gas embolism. After restoration of normal cardiac activity, the operation was completed after conversion to an open approach. When using the argon coagulator it is necessary to prevent excessive intra-abdominal pressure due to the flow of argon gas and to avoid injury to the hepatic veins, which may cause gas embolism.
本文报告了我们对1例恶性病变和3例良性病变进行4次小范围切除术的初步经验。通过机械破碎和水刀进行解剖。氩束系统有效地实现了凝血。较大的血管用夹子夹闭。3例患者接受了腹腔镜治疗，术后恢复顺利，很快出院。另1例患者（肝硬化肝脏中的小肝细胞癌）术中发生心脏骤停，可能是由于气体栓塞。恢复正常心脏活动后，转为开放手术完成了手术。使用氩气凝血器时，有必要防止因氩气流导致的腹腔内压力过高，并避免损伤肝静脉，以免引起气体栓塞。
