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find Author "修典荣" 4 results
  • 腹膜后肿瘤的微创手术治疗

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  • 腹腔镜与内镜治疗肝外胆管结石(附87例报道)

    目的探讨腹腔镜与内镜两种不同方法在肝外胆管结石治疗中的临床应用价值。 方法回顾性分析2008年7月至2014年8月期间收治的87例单纯肝外胆管结石患者的临床资料。 结果2组在术后肠功能恢复时间及取石成功率比较差异无统计学意义(P>0.05)。内镜组的手术时间、住院时间及术中出血均明显少于腹腔镜组(P<0.05)。随访2个月~6年(平均3.5年),腹腔镜和内镜组各有4例胆道感染和2例胰腺炎。另外,腹腔镜组2例结石复发;内镜组有1例结石复发,1例胆管出血,1例胆管狭窄。2组并发症发生率比较,差异无统计学意义(P>0.05)。 结论肝外胆管结石较大、较多时适合应用腹腔镜治疗,胆管未扩张的较小结石或有上腹手术史的结石则应用内镜治疗较合理。内镜在肝外胆管结石治疗中较腹腔镜显示出更大微创优势。

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  • 4 例肠道内瘘患者行转流治疗的临床分析

    目的探讨转流手术在肠道内瘘治疗中的应用价值。方法回顾性分析 2016 年在北京大学第三医院行转流手术治疗的 4 例肠道内瘘患者的临床资料。结果病例 1,直肠癌术后出现右侧输尿管瘘,先于膀胱镜下行右侧输尿管支架置入术,术后症状短暂缓解,后肛门溢液再次出现,且逐渐发展为右肾积水, 3 个月后又行右侧经皮肾造瘘术。病例 2,直肠癌术后出现尿道瘘,行腹腔镜横结肠双腔造瘘术。病例 3,乙状结肠憩室炎导致结肠膀胱瘘,行腹腔镜探查、开腹膀胱后壁分离、膀胱瘘修补、结肠修补及末端回肠双腔造瘘术。病例 4,盆腔肿瘤复发导致小肠阴道瘘,行腹腔镜末端回肠双腔造瘘术。4 例患者术后 1 周内原有症状消失,手术效果良好。术后随访 3 个月~1 年,病例 1 和病例 4 肿瘤原位复发;病例 2 于术后 6 个月行经肛门尿道修补手术成功;病例 3 于术后 6 个月时瘘口愈合,行造瘘口还纳术。结论转流手术治疗肠道内瘘具有重要价值,但应严格把握适应证,并重视术后随访。

    Release date:2017-09-18 04:11 Export PDF Favorites Scan
  • Laparoscopic Resection of Primary Retroperitoneal Tumors: A 10-Year Experience of Single-Center

    ObjectiveTo evaluate the safety and feasibility of laparoscopic resection of primary retroperitoneal tumors. MethodClinical data of 52 patients diagnosed as primary retroperitoneal tumor who underwent laparoscopic resection in Peking University Third Hospital from January 2006 to December 2015 were retrospectively collected and analyzed. ResultsFifty two patients were included in the review. In 21 patients (40.3%), tumors were adjacent to major vessels (such as inferior vena cava, superior mesenteric vein, and the splenic vessel), tumors of 31 patients (59.7%) were away from major vessles. Two operations (3.8%) were converted to hand-assistant and 2 operations (3.8%) were converted to laparotomy due to tight adherence to major vessels. The mean value of operative time was 171.4-minute (60-520 minutes) and the mean value of length of incision was 2.8 cm (1-15 cm), the mean value of estimated blood loss was 86.4 mL (10-1 150 mL), 2 patients needed blood transfusion. The mean value of time of returning to diets was 1.5-day (1-5 days) and the mean value of length of postoperative hospital stay was 4.9-day (1-16 days). There was no major postoperative complications or death. Follow up was available for 47 patients at a median time of 62.0-month (4-120 months). Three patients with retroperitoneal liposarcomas experienced recurrence at 31, 34, and 48 months after operation, 1 patient with mucinous peripheral neurilemmoma experience recurrence at 69 months after operation, all of which underwent further resection, with others experiencing no recurrence or metastasis. Three patients died in reason of other diseases. ConclusionsLaparoscopic surgery can be performed safely in the treatment of primary retroperitoneal tumors, even when a tumor adjacent to major vascular structures.

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