简介:目的:探讨经腹腔镜辅助行肝门解剖和肝门肠吻合术治疗先天性胆道闭锁的临床效果.方法:先天性胆道闭锁患儿12例,29~87d11例,5.5个月1例.2例为肝总管闭锁(Ⅱ型),肝门部有直径1.2~2.5cm囊肿与肝内胆管相通;10例为肝门部胆管闭锁(Ⅲ型).于脐部纵切口置入10mmTrocar,然后分别于右上腹、右中腹和左上腹置入3个5mmTrocar.术中胆道造影,确诊为胆道闭锁,暴露肝门;切除胆囊,游离切除肝门纤维块,空肠行Roux-en-Y吻合术保留肝支30~35cm,然后将肠管送回腹腔,将空肠肝支经结肠后拉至肝门下;用5-0可吸收缝线将空肠与肝门端侧连续吻合.结果:本组12例患儿中1例因肝门渗血中转开腹手术;另11例均在腹腔镜辅助下完成手术,手术时间平均为3.5h(3.1~4.6h),出血量约10ml,没有需在术中和术后输血者,全组患儿无手术后肠粘连梗阻和腹腔感染.结论:经腹腔镜行肝门肠吻合术治疗先天性胆道闭锁安全可靠,具有暴露肝门清晰、肝门纤维块分离和切除准确、对患儿打击小等优点.
简介: 【摘要】 目的 探讨直肠外翻切除吻合术治疗直肠癌的临床效果及应用价值。方法 以 2017年 1月—— 2019年 6月期间收治的 37例直肠癌患者为研究对象,对其临床资料进行回顾性分析,观察手术成功率、术后并发症发生率,随访五年,观察复发率及 5年生存率。结果 37例患者的手术均获成功,术后患者按照肛门节制大便功能评价,优 22例,良 12例,差 3例,优良率为 91.89%,无吻合漏、大便失禁等并发症发生, 5年内复发 3例,复发率为 8.10%, 5年观察期结束,生存 30例,生存率为 81.08%。结论 经直结肠外翻切除吻合术治疗直肠癌可有效治疗直肠癌,患者术后大部分控便能力良好,生活质量得到提高,并且复发率较低,五年生存率较高,具有较高的临床应用价值,可推广应用。 【关键词】 直肠癌外翻切除吻合术;直肠癌;临床分析 [Abstract] Objective To explore the clinical effect and application value of eversion resection and anastomosis in the treatment of rectal cancer. Methods the clinical data of 37 patients with rectal cancer from January 2017 to June 2019 were analyzed retrospectively. The success rate of operation, the incidence of postoperative complications, the recurrence rate and 5-year survival rate were observed. Results the operation of 37 cases was successful. According to the evaluation of anal continence, 22 cases were excellent, 12 cases were good, 3 cases were poor, the excellent and good rate was 91.89%. There was no anastomotic leakage, fecal incontinence and other complications. 3 cases recurred within 5 years, the recurrence rate was 8.10%, the 5-year observation period ended, 30 cases survived, the survival rate was 81.08%. Conclusion the treatment of rectal cancer with rectocellular eversion resection and anastomosis can effectively treat rectal cancer. Most of the patients have good defecation control ability, improved quality of life, low recurrence rate and high five-year survival rate. It has high clinical application value and can be widely used.
简介: 【摘要】 目的 探讨直肠外翻切除吻合术治疗直肠癌的临床效果及应用价值。方法 以 2017年 1月—— 2019年 6月期间收治的 37例直肠癌患者为研究对象,对其临床资料进行回顾性分析,观察手术成功率、术后并发症发生率,随访五年,观察复发率及 5年生存率。结果 37例患者的手术均获成功,术后患者按照肛门节制大便功能评价,优 22例,良 12例,差 3例,优良率为 91.89%,无吻合漏、大便失禁等并发症发生, 5年内复发 3例,复发率为 8.10%, 5年观察期结束,生存 30例,生存率为 81.08%。结论 经直结肠外翻切除吻合术治疗直肠癌可有效治疗直肠癌,患者术后大部分控便能力良好,生活质量得到提高,并且复发率较低,五年生存率较高,具有较高的临床应用价值,可推广应用。 【关键词】 直肠癌外翻切除吻合术;直肠癌;临床分析 [Abstract] Objective To investigate the clinical effect and application value of rectal valgus resection and anastomosis in the treatment of rectal cancer. Methods The clinical data of 37 patients with rectal cancer admitted from January 2017 to June 2019 were retrospectively analyzed. The success rate of operation and the incidence of complications after operation were observed. The recurrence rate and 5-year survival rate were followed up for 5 years. Results All 37 patients were successfully operated. According to the evaluation of anal defecation control function, 22 cases were excellent, 12 cases were good and 3 cases were poor. The excellent and good rate was 91.89%. There were no complications such as anastomotic leakage and fecal incontinence. Three cases recurred within 5 years, the recurrence rate was 8.10%. At the end of 5-year observation period, 30 cases survived and the survival rate was 81.08%. Conclusion Transrectal valgus resection and anastomosis for rectal cancer can effectively treat rectal cancer. Most of the patients have good defecation control ability, improved quality of life, low recurrence rate, high five-year survival rate and high clinical application value.
简介:临床资料本组64例(均为1996年1月至2000年12月我院收治病例).男38例,女26例,年龄37~86(平均61)岁.左结肠梗阻38例,右结肠梗阻26例;结直肠癌46例,结肠扭转7例,炎性肠道疾病6例,结肠外肿瘤侵及结肠4例,胃癌术后结肠粘连1例.其中盲肠穿孔5例,病变部位穿孔3例,占125%(8/64例).行右结肠切除吻合21例,左结肠切除吻合28例,横结肠造口6例,Hartmann手术4例,短路手术5例.左结肠切除吻合常规经盲肠插管行术中结肠灌洗.右及左结肠切除吻合术后发生吻合口瘘各1例.死亡3例,均为结肠坏死穿孔行结肠造口术后的高龄患者,死因均为并发肺部感染后的脏器功能衰竭.
简介:摘要目的探讨"双U"三步法胰肠吻合术(PJ)在机器人胰十二指肠切除术(RPD)中的可行性。方法回顾性分析2017年6月至2019年6期间行RPD的28例患者病例资料,对术中情况及术后并发症进行分析。结果28例患者均顺利完成手术,"双U"三步法吻合时间为17~35 min,平均23.5 min,术中出血量50~600 ml,平均178.3 ml。术后5例患者出现并发症,其中3例(8.6%)出现术后胰瘘(POPF),均为B级,经抑制胰液分泌,延长腹腔引流时间及营养支持治疗后痊愈。2位患者出现胃排空延迟,经保守治疗后康复出院。平均术后住院时长13.9 d(3~63 d),无住院期间死亡病例。结论"双U"三步法PJ操作简便,利于学习,吻合质量安全可靠,愈合快,应用范围广,对减少并发症及降低POPF有一定优势。
简介:【摘要】目的 对比腹腔镜胆管空肠吻合术与开腹胆管空肠吻合术临床治疗的疗效对比分析。方法 将2021年1月-2023年12月期间收治的胆管囊肿患者48例均分为A(n=24,开腹胆管空肠吻合术)、B(n=24,腹腔镜胆管空肠吻合术治疗)两组,并对比疗效。结果 B组较A组手术用时、术中出血量、术后住院天数、引流时间、并发症发生率均更少,对比均有统计学意义(P〈0.05)。结论 腹腔镜胆管空肠吻合术治疗胆总管囊肿较开腹胆管空肠吻合术的安全性更高,同时减少术中出血量,并加快术后康复速度,值得推广 。
简介:我院2005年2月至2008年9月施行124例胃大部切除,其中合并2型糖尿病(T2DM)36例。回顾分析胃大部切除术后不同的消化道重建方式对T2DM患者术后血糖的影响,报告如下。
简介:摘要目的探讨腹腔镜下直肠癌低位切除吻合术的手术配合与护理。方法随机抽取我院自2012年1月至6月期间收治32例确诊为直肠癌的患者的临床资料,在腹腔镜下行直肠癌低位(5~7cm)切除吻合术的治疗效果;完善术中手术配合的护理常规,观察术后患者并发症发生情况的处理及护理措施等。结果32例患者经手术治疗后获得成功,无一例死亡。手术时间在150~300,平均时长±210min,术后出血量为50~150ml,平均出血量±100ml;患者术后1~2d胃肠功能恢复,可进流质食物,下床活动;未发生严重的并发症;术后切缘病理检查未见癌细胞。结论行腹腔镜下直肠癌低位切除吻合术,手术室护士充分细致的术前准备、娴熟的术中配合是手术成功重要保障之一,同时术前详细了解患者状况,手术要求及各环节做好配合工作,是患者术后早日康复的关键因素之一。