CAJ | 학술논문

目的探索和建立使用传统腹腔镜手术器械的经阴道阑尾切除术的技术和方法.方法选择中国医科大学附属盛京医院妇科2010年11月至2011年11月3例既往有反复发作的慢性阑尾炎病史的子宫肌瘤患者在阴式子宫切除术完成后暂不闭合阴道断端,经阴道断端置入Trocar,导入腹腔镜和传统腹腔镜手术器械施行经阴道阑尾切除,手术结束闭合阴道断端.收集分析手术时间、出血量、术后并发症发生率、出院时间等临床资料.结果 3例经阴道人路手术均成功完成.阑尾切除部分手术时间分别为34、23和26 min,术中均无明显失血,术后均无阑尾残端瘘等并发症发生,术后3d痊愈出院,与传统多孔法和经脐单孔法腹腔镜阑尾切除术相比无明显差异且腹部无任何瘢痕.结论成功建立了经阴式子宫切除后的阴道断端施行阑尾切除术的技术和方法,且该术式安全可行,是经自然腔道内镜手术在临床上的新探索.
목적 탐색화건립사용전통복강경수술기계적경음도란미절제술적기술화방법.방법 선택중국의과대학부속성경의원부과2010년11월지2011년11월3례기왕유반복발작적만성란미염병사적자궁기류환자재음식자궁절제술완성후잠불폐합음도단단,경음도단단치입Trocar,도입복강경화전통복강경수술기계시행경음도란미절제,수술결속폐합음도단단.수집분석수술시간、출혈량、술후병발증발생솔、출원시간등림상자료.결과 3례경음도인로수술균성공완성.란미절제부분수술시간분별위34、23화26 min,술중균무명현실혈,술후균무란미잔단루등병발증발생,술후3d전유출원,여전통다공법화경제단공법복강경란미절제술상비무명현차이차복부무임하반흔.결론 성공건립료경음식자궁절제후적음도단단시행란미절제술적기술화방법,차해술식안전가행,시경자연강도내경수술재림상상적신탐색.
Objective To establish the technique and methodology of appendectomy through transvaginal natural orifice transluminal endoscopic surgery (NOTES)under laparoscopy.Methods Three cases of chronic appendicitis were selected to receive laparoscopic transvaginal resection of appendixes with concurrent vaginal hysterectomies for uterine fibroids at Shengjing Hospital of China Medical University from November 2010 to November 2011.The procedure was performed by a multidisciplinary team composed of surgeons and gynecologists.The clinical data such as operative duration,bleeding volume,morbidity and stay duration were collected and analyzed.Results Appendectomies were performed with the working laparoscopic tools inserted through vagina. The en bloc resection was removed transvaginally through laparoscope.It took 34,23 and 26 minutes respectively to complete the appendectomies.And the blood loss volume was minimal.There were no postoperative complications.And the patients were discharged scar-free after 3 days.Conclusions Transvaginal appendectomy is both feasible and safe when performed by a multidisciplinary team.As an emerging innovation,natural orifice transluminal endoscopic surgery is miniinvasive,better tolerated and more respectful of esthetics.