CAJ | 학술논문

目的探讨手辅助腹腔镜(手助腔镜)脾切除术加门奇断流术的临床效果.方法选择2008年1月至2012年6月在我院住院手术的30例门脉高压患者.分别采用手助腔镜(16例)和完全腹腔镜(全腔镜,14例)进行脾切除加门奇断流术,并对两组患者的临床效果进行对比分析.结果两组患者手术均顺利完成.手助腔镜组和全腔镜组手术时间分别为(270±21) min和(350±19) min,P＜0.05；术中出血量分别为(250±53) ml和(370±45) ml,P＜0.05；住院费用分别为(3.0±0.2)万元和(3.5±0.4)万元,P＜0.05；而术后排气时间、术后进半流质饮食时间、住院时间、并发症发生率两组差异无统计学意义(均为P＞0.05).结论手助腔镜脾切除加门奇断流术同样具备全腔镜手术微创、安全、术后恢复快的优点.
목적 탐토수보조복강경(수조강경)비절제술가문기단류술적림상효과.방법 선택2008년1월지2012년6월재아원주원수술적30례문맥고압환자.분별채용수조강경(16례)화완전복강경(전강경,14례)진행비절제가문기단류술,병대량조환자적림상효과진행대비분석.결과 량조환자수술균순리완성.수조강경조화전강경조수술시간분별위(270±21) min화(350±19) min,P＜0.05；술중출혈량분별위(250±53) ml화(370±45) ml,P＜0.05；주원비용분별위(3.0±0.2)만원화(3.5±0.4)만원,P＜0.05；이술후배기시간、술후진반류질음식시간、주원시간、병발증발생솔량조차이무통계학의의(균위P＞0.05).결론 수조강경비절제가문기단류술동양구비전강경수술미창、안전、술후회복쾌적우점.
Objective To study the clinical efficacy of splenectomy plus porta-azygous devascularization in the treatment of portal hypertension using either the hand-assisted laparascopic (HALS) or the laparoscopic approaches.Methods The clinical data of 30 cases of portal hypertension treated between January 2008 and June 2012 were enrolled in this study.16 patients underwent HALS and 14 patients underwent traditional laparoscopy approach.Results All the operations were successfully accomplished.The mean operation time of the HALS group was significantly shorter than the traditional laparoscopic group (270 min vs 350 min,P＜0.05).Intra-operative blood loss of the HALS group was significantly less than the traditional laparoscopic group (250 ml vs 370 ml,P＜0.05).The median overall costs were significantly lower in the HALS group (30000 RMB vs 35000 RMB,P＜0.05).There were no significant differences in the time to return to oral diet,the length of hospital stay,and the time to passage of flatus.The complication rates between the two groups were similar.Conclusion Hand-assisted laparoscopic surgery had the advantages over conventional laparoscopic surgery in minimal invasiveness,safety,and quicker postoperative recovery.