腹腔镜探查并治疗腹部恶性肿瘤术后肠梗阻的临床研究

目的:探讨腹腔镜辅助探查并治疗腹部恶性肿瘤术后肠梗阻患者的可行性及安全性。方法:应用腹腔镜技术对我院42例腹部恶性肿瘤术后患者行手术治疗,其中包括良性粘连性肠梗阻14例、肿瘤复发16例、原发性结肠癌1例、恶性肠粘连11例。结果:42例患者均在腹腔镜下明确诊断,其中18例患者在完全腹腔镜下手术治疗,13例患者在腹腔镜辅助下行手术治疗,6例患者腹腔严重粘连中转开腹手术治疗,5例患者腹腔广泛转移行保守治疗。腹腔镜手术时间为35~290min,平均住院日9.2±1.7d。患者术后疼痛较轻、下床活动时间及肠道功能恢复时间短、术后并发症少。结论:恶性肿瘤术后肠梗阻患者仍需手术治疗,在严格掌握手术适应症下,应用腹腔镜技术对恶性肿瘤术后肠梗阻病人的治疗是安全、可行的。

Laparoscopic Exploration and Treatment the Patients of Ileus after Abdomen Malignant Tumor Postoperative

Objective:To explore the feasibility and security of laparoscopic exploration and treatment the patients of ileus after Abdomen Malignant tumor postoperative.Methods:A total of 42 Abdomen Malignant tumor postoperative patients in our hospital receiced laparoscopic exploration and treatment. Including benignant adhesive ileus 14 cases, neoplasm recurrence 16 cases, Primary colon cancer 1 case, and malignant adhesive ileus 11 cases.Results:42 patients were all clarify diagnosis with laparoscopic, 18 cases were Totally laparoscopic surgery, 13 cases were Laparoscopic assisted surgery, 6 cases were Abdomen severe adhesion transfer laparotomy surgery. 5 cases were conservative treatment due to the widespread peritoneal metastasis. The operation time was 35~290 min and average hospital stay was 9.2± 1.7 d. The patients postoperative Pain was lighter, the first ambulation time and recovery of gastrointestinal function were shorter and fewer complications.Conclusion:The patients of ileus after Abdomen Malignant tumor postoperative also need operative treatment. Under the strict control operation indications, laparoscopic surgery treatment is feasibility and security for the patients of ileus after Abdomen Malignant tumor postoperative.