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目的探讨普外科行腹腔镜胆囊切除同期行妇科子宫及附件联合手术的可行性和优势。方法 2009年1月-2013年12月普外科和妇科选择35~55岁中年女性胆囊结石合并子宫肌瘤、卵巢囊肿、输卵管粘连等妇科良性疾病患者60例,入选条件胆囊结石,胆囊壁厚<0.5 cm,非急性炎症期,妇科疾病均有症状,瘤体5.0~10.0 cm。在年龄、体质(胖瘦)、病理类型大致相同对比情况下,根据患者的意愿分为腹腔镜联合手术(GLS)组和分期手术组(对照组),观察比较两组麻醉时间、手术时间、腹壁戳孔数、住院时间、总费用等情况。结果 CLS组均一次手术成功,术后肝功能异常2例,分别经保肝治疗5~6 d恢复正常。对照组二次手术时2例因脐部及腹腔粘连中转开腹;两组患者无切口感染,无医源性组织器官损伤,均治愈出院。CLS组在麻醉时间、手术时间、腹壁戳孔数、住院时间、费用较对照组有明显优势,两组比较差异有统计学意义(P<0.05)。结论在胆囊结石联合妇科手术方面,GLS安全可行、美观、经济、实用。
Objective To investigate the feasibility and advantage of combined surgery of gynecological womb and accessories in general surgery laparoscopic cholecystectomy. Methods From January 2009 to December 2013, 60 cases of gynecological benign diseases including cholesteatoma, ovarian cyst and tubal adhesions were selected from 35 to 55 years old women aged 35-55 years. There were 60 cases of cholecystolithiasis, gallbladder wall thickness <0.5 cm, non-acute inflammation, gynecological diseases are symptoms, the tumor 5.0 ~ 10.0 cm. According to the wishes of the patients, they were divided into laparoscopic surgery group (GLS group) and staged surgery group (control group) under the same age, physical constitution (fat and thin) and pathological types. The anesthesia time, operation time, Abdominal wall poke hole number, hospital stay, the total cost and so on. Results In the CLS group, all the operations were performed successfully. Two cases of postoperative liver dysfunction were recovered. The patients in CLS group returned to normal after 5 ~ 6 days of treatment. In the control group, 2 cases underwent open laparotomy due to umbilical cord and abdominal adhesions during the second operation. No incision infection and no iatrogenic tissue and organ injury were found in both groups. All patients were cured and discharged. There were significant differences between the two groups in the time of anesthesia, the operation time, the number of punctured abdominal wall, the length of hospital stay and the cost of the control group. There was significant difference between the two groups (P <0.05). Conclusions GLS is safe and feasible, beautiful, economical and practical in gallstone surgery combined with gynecological surgery.