【摘要】 目的 探討腹部手術史對急性闌尾炎腹腔鏡闌尾切除術（LA）的影響。 方法 2005年1月-2010年9月，將既往有腹部手術史并行LA的111例患者納入觀察組，同期隨機抽取無腹部手術史行LA的220例患者納入對照組。入選患者排除多次手術史、免疫功能低下、肝腎功能不全及血液病。比較兩組中轉開腹率、手術時間、術中出血量、術后并發癥及住院時間的差異。 結果 兩組均未出現術中并發癥及死亡，兩組患者的中轉開腹率、手術時間、術中出血量、術后并發癥及住院時間比較，差異均無統計學意義（Pgt;0.05）。 結論 即往腹部手術史對急性闌尾炎LA沒有明顯影響。【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.
