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目的比较有下腹部开腹手术史的卵巢良性肿瘤患者行再次开腹手术或腹腔镜手术的特点,探讨有下腹部开腹手术史的卵巢良性肿瘤行腹腔镜手术的优点、操作技巧及应用价值。方法回顾分析2004年2月至2008年10月有下腹部开腹手术史的卵巢良性肿瘤患者32例,其中腹腔镜手术17例(腹腔镜组),再次开腹手术15例(开腹组),比较两组手术时间、术中出血量、住院时间、术后恢复情况。结果腹腔镜组手术时间、术中出血量、肛门排气时间、术后平均住院日及术后发热、感染、镇痛例数、术后感染例数均明显少于开腹组(P<0.05)。结论有下腹部开腹手术史的卵巢肿瘤腹腔镜手术较再次开腹手术有手术时间短、创伤小、出血量少、术后恢复快、体表瘢痕小、并发症少等优点,适于临床应用。
Objective To compare the characteristics of laparoscopic or open laparoscopic surgery in patients with benign ovarian tumors who have history of lower abdominal open surgery and to explore the advantages, operating skills and application value of laparoscopic surgery for benign ovarian tumors with a history of lower abdominal open surgery . Methods A retrospective analysis of 32 cases of benign ovarian tumors with a history of open lower abdominal surgery from February 2004 to October 2008 was performed. Laparoscopic surgery was performed in 17 cases (laparoscopic group) and laparotomy in 15 cases (laparotomy group) The operation time, intraoperative blood loss, hospital stay and postoperative recovery were compared between the two groups. Results The laparoscopic operation time, intraoperative blood loss, anal exhaust time, postoperative average length of stay and postoperative fever, infection, the number of cases of analgesia and postoperative infections were significantly less than those of the laparotomy group (P <0.05 ). Conclusions Laparoscopic surgery for ovarian tumors with a history of lower abdominal surgery has the advantages of shorter operation time, less trauma, less bleeding, faster postoperative recovery, less scar on the body surface and fewer complications than laparotomy, which is suitable for clinical application.