多学科腹腔镜联合手术的临床应用

目的探讨多学科腹腔镜联合手术在微创外科中的应用价值。方法28例多学科腹腔镜联合手术的患者中术前明确诊断拟行联合手术25例，术中腹腔镜探查发现而行联合手术3例。其中联合妇科手术22例，分别行腹腔镜胆囊切除（LC）＋腹腔镜妇科手术17例，腹腔镜阑尾切除（LA）＋腹腔镜妇科手术5例。联合泌尿外科手术5例，行LC＋腹腔镜下肾囊肿开窗引流术3例，LC＋腹腔镜下输尿管切开取石术2例，联合胸外科手术1例。结果手术35-190min，平均手术95min，术中出血5-120mL，术后住院3-8d，平均5．6d，术后肠功能恢复时间6-36h，平均24h，术后疼痛轻微。28例手术均获得成功，无1例中转开腹，无相关并发症发生。结论多学科腹腔镜联合手术是安全有效的，充分体现了微创外科的优越性，但应严格掌握手术适应证。

Clinical application on combined multi-disciplinary laparoscopic surgery

Objective] To study the clinical application on combined multi-disciplinary laparoscopic surgery. Methods] Twenty eight patients were undergone combined multi-disciplinary laparoscopic surgery. Twenty five cases were diagnosed before performed and three cases during operations. Seventeen patients were performed laparoscopic cholecystectomy(LC) plus laparoscopic gynecological operation. Five patients were performed laparoscopic appendectomy (LA) plus laparoscopic gynecological operation. Three patients were performed LC plus laparoscopic fenestration of kidney. Two patients were performed LC plus laparoscopic ureterolithotomy. One patient was performed LC plus thoracoscopic operation. Result] The operation time was 35~190 min (average 95). Bleeding range from 5 ml to 120 mL. The pain after surgery was light. All patients were recovered satisfied. There was no conversion to open surgery, nor complication occurred. Conclusions] Combined multi-disciplinary laparoscopic surgery can be performed safely and effectively. It can reduce the pain of patients and the cost. But the indication must be well controlled.