【摘要】 目的 探讨腹部手术史对急性阑尾炎腹腔镜阑尾切除术（LA）的影响。 方法 2005年1月-2010年9月，将既往有腹部手术史并行LA的111例患者纳入观察组，同期随机抽取无腹部手术史行LA的220例患者纳入对照组。入选患者排除多次手术史、免疫功能低下、肝肾功能不全及血液病。比较两组中转开腹率、手术时间、术中出血量、术后并发症及住院时间的差异。 结果 两组均未出现术中并发症及死亡，两组患者的中转开腹率、手术时间、术中出血量、术后并发症及住院时间比较，差异均无统计学意义（Pgt;0.05）。 结论 即往腹部手术史对急性阑尾炎LA没有明显影响。【Abstract】 Objective To investigate the effect of previous abdominal surgery on appendectomy under laparoscope for acute appendicitis. Methods From January 2005 to September 2010, 111 patients with a history of abdominal surgery who had undergone laparoscopic appendectomy due to acute appendicitis were in the observe group and 220 patients selected randomly from the patients without a history of previous abdominal surgery who had undergone laparoscopic appendectomy were in the control group. The patients with a history of multiple operations, immunodeficiency, liver and kidney dysfunction, and hematopathy were excluded. The data were collected retrospectively and the differences of conversion rate, operative time, intraoperative blood loss, postoperative complications, and hospital staying were compared between the two groups. Results There were no death or intraoperative complications in both of the two groups. The differences in the conversion rate, operative time, intraoperative blood loss, postoperative complication rates, and hospital staying between the two groups were not significant (Pgt;0.05). Conclusion Previous abdominal surgery has no significant effect on laparoscopic appendectomy for acute appendicitis.
Objective To discuss the clinical application of totally laparoscopic surgery combined with intraoperative removed the specimen through the oral in treatment for gastric stromal tumor. Methods The clinical data of 20 patients diagnosed gastric stromal tumor and performed totally laparoscopic surgery combined with intraoperative removed the specimen through the oral in treatment for gastric stromal tumor from January 2007 to August 2009 in our hospital were analyzed retrospectively. Results All the cases were performed successfully laparoscopic operation. The operation time was （110±35） min， intraoperative bleeding was （60±15） ml，postoperative hospital stay was （6.5±1.2） d. No postoperative complications occurred. There were 19 cases no relapse during 0.5-2.5 years with (1.8±0.2) years of follow-up. One patient with recurrence was performed the laparoscopic proximal subtotal gastrectomy. Conclusions Totally laparoscopic surgery combined with intraoperative removed the specimen through the oral in treatment for gastric stromal tumor is safe， feasible， and minimally invasive for patients due to its clearness of dissection， less bleeding， and removed the specimen through natural channel.