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[腹腔镜治疗腹部急症的结果]

[Results of laparoscopic treatment of abdominal emergencies].

作者信息

Henry C, Smadja C, Vons C, Bobocescu E, Mariette D, Tahrat M, Franco D

机构信息

Service de Chirurgie Générale Hôpital Antoine-Béclère, Clamart.

出版信息

Ann Chir. 1998;52(3):223-8.

PMID:9752449
Abstract

The purpose of this retrospective study was to evaluate the results of the laparoscopic surgical treatment of abdominal emergencies. From May 1991 to September 1995, 200 patients operated by laparoscopy for an acute abdomen were included in this study. The decision to treat the patient by laparoscopy was taken by the surgeon on duty. There were 101 males and 99 females with a mean age of 41 +/- 20 years (range 11-90 years). The main indications for operation were: acute appendicitis (109 patients), acute cholecystitis (52 patients), small bowel obstruction (14 patients) and perforated duodenal ulcer (14 patients). There was no hospital mortality. One per cent of patients experienced an operative complication which was treated by laparotomy. Conversion to laparotomy was needed in 13% of cases. The morbidity rate was 9% and reoperation by laparotomy for acute generalized peritonitis secondary to small bowel perforation was necessary in two cases. Mean postoperative hospital stay ranged from 4 to 7 days. The authors conclude that surgical laparoscopic treatment of the common abdominal emergencies is safe. The conversion rate is low as is the complication rate. These conclusions should be confirmed by a prospective study.

摘要

本回顾性研究的目的是评估腹腔镜手术治疗腹部急症的效果。1991年5月至1995年9月,本研究纳入了200例行腹腔镜急性腹部手术的患者。是否采用腹腔镜治疗由值班外科医生决定。其中男性101例,女性99例,平均年龄41±20岁(范围11 - 90岁)。主要手术指征为:急性阑尾炎(109例)、急性胆囊炎(52例)、小肠梗阻(14例)和十二指肠溃疡穿孔(14例)。无医院死亡病例。1%的患者出现手术并发症,经剖腹手术治疗。13%的病例需要转为剖腹手术。发病率为9%,2例因小肠穿孔继发急性弥漫性腹膜炎需再次剖腹手术。术后平均住院时间为4至7天。作者得出结论,腹腔镜手术治疗常见腹部急症是安全的。中转率和并发症发生率都很低。这些结论应通过前瞻性研究加以证实。

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