CAJ | 학술논문

目的：探讨腹腔镜手术治疗粪石性小肠梗阻的临床价值。方法2011年5月～2013年11月对17例粪石性小肠梗阻在腹腔镜下找到梗阻部位，明确粪石性肠梗阻诊断后，以无损伤肠钳将粪石轻柔捏挤，然后将碎块连同肠内容物推挤过回盲瓣，检查梗阻近端肠管无粪石后结束手术。结果16例腹腔镜手术获成功，1例因粪石大且坚硬，嵌顿在肠管无法推动，反复在同一部位挤压粪石导致水肿肠管浆膜破裂，中转开放手术。腹腔镜手术时间12～29 min，平均21 min。16例术后住院2～6 d，平均4．2 d。术后随访3～6个月，腹腔镜手术成功患者无腹腔脓肿、肠漏、粘连性肠梗阻、切口感染等并发症，腹部瘢痕不明显。结论腹腔镜诊治粪石性小肠梗阻安全、简单、有效。
목적：탐토복강경수술치료분석성소장경조적림상개치。방법2011년5월～2013년11월대17례분석성소장경조재복강경하조도경조부위，명학분석성장경조진단후，이무손상장겸장분석경유날제，연후장쇄괴련동장내용물추제과회맹판，검사경조근단장관무분석후결속수술。결과16례복강경수술획성공，1례인분석대차견경，감돈재장관무법추동，반복재동일부위제압분석도치수종장관장막파렬，중전개방수술。복강경수술시간12～29 min，평균21 min。16례술후주원2～6 d，평균4．2 d。술후수방3～6개월，복강경수술성공환자무복강농종、장루、점련성장경조、절구감염등병발증，복부반흔불명현。결론복강경진치분석성소장경조안전、간단、유효。
Objective To evaluate the clinical application of laparoscopy in small bowel obstruction due to stercolith . Methods Clinical data of 17 cases of small bowel obstruction due to stercolith , who received laparoscopic operation in our hospital from May 2011 to November 2013, were analyzed retrospectively .After the obstruction site was oriented and the diagnosis was clarified under laparoscope , the stercolith was softly broken by using forceps with non-traumatic teeth , and then was pushed through the ileocecal valve . Results The procedures were completed smoothly in 16 patients, and a conversion to open surgery was required in 1 patient due to repeated pushing of a large and hard stercolith leading to rupture of the intestinal serosa .In the 16 cases, the mean operation time was 21 min (range, 12-29 min) and the mean length of postoperative hospital stay was 4.2 days (range, 2-6 d). Follow-up was achieved in 16 cares for 3 -6 months, during which no postoperative celiac abscess , intestinal leakage , adhesive intestinal obstruction , or incision infection occurred .No obvious abdominal scar formation developed . Conclusion Laparoscopic surgery for small bowel obstruction due to stercolith is a safe , simple, and effective procedure .