肠切除术

MATERIALS AND METHODS The clinical data of 47 cases of patients Underwent laparoscopic adrenectomy and 10 cases of patients underwent open adrenalectomy were analyzed retrospectively.

回顾分析47例腹腔镜肾上腺髓质脂肪瘤切除术和开放肾上腺髓质脂肪瘤切除术的临床资料，统计分析这两种术式在手术时间、术中出血量、术后肠功能恢复时间、术后住院时间及并发症发生率等的差异。

Objective:to investigate the effect of damage control surgeryin the theatment ofacute mesenteric ischemia.methods: a retrospective analysis was made on clinical data of eight cases with ami treated by dcs from june 2006 to december 2007.results: operations were immediately performed in all eight patients with ami after final diagnosis,including six cases treated with different limitation of enterotomy; five with temporary abdominal closure and exteriorization of intestine,three with abdominal closure of venous nutrition transfusion container; seven with two-stage operation in different means.five cases survived or improved three died, one of which died two months after discharge due to short bowel syndrome.conclusion:it is very difficult to treat the ami patients owing to the restriction of technology and equipment.

目的：探讨损伤控制外科在治疗急性肠系膜缺血疾病中的应用。方法：对2006年6月~2007年12月应用dcs理念指导救治的8例急性肠系膜缺血疾病的临床资料进行回顾性分析。结果：对8例急性肠系膜血管缺血疾病均于确诊后立即手术探查，其中6例做了不同范围的肠切除；5例做暂时关腹术加肠外置，3例用静脉营养输液袋关腹；7例进行不同方式的二期手术。本组5例痊愈或好转出院；3例死亡，其中1例为短肠综合征出院2个月后死亡。结论：在治疗急性肠系膜血管缺血疾病病人的治疗中，在许多医院因设备和技术等条件的限制，处理十分困难。

Methods 11 cases were preformed with cooperating fiber colonoscopy during operation. Of which 5 cases were radical resection of sigmoid cancer and polypus. 6 cases were radical resection of rectal cancer.

在腹腔镜结直肠癌切除术中应用结肠镜完成11例，其中5例根治切除乙状结肠癌及息肉肠段，6例根治切除直肠癌。

Firstly,all patients have been excided the upper ductus choledochus,the liver gross duct,left right liver duct besides one centimeter of liver duct that lies upwards the hepatolith.Secondly, we have sutured the excided bile duct, which has been shaped acetabuliform,lifted one part of jejunums,intered non-port one subcuneously,and then inosculated gall with enteron by Roux-en-Y way.Lastly,we have partly excised the ill liver in regular way.Results 26 ones have been follow-up for 1～10 years.The rate is 81 percents,average for 6 years.

32例肝内胆管结石均接受皮下盲袢型胆肠吻合术，其中结石位于右肝7例（22%），左肝9例（28%），两肝均有16例（50%）；结石合并肝胆管狭窄24例（75%），全部病例均切开胆总管上部、肝总管、左右肝管，并切开肝内胆管狭窄部以上1cm肝管，将切开的胆管做必要的缝合，形成碟状，取一段空肠上提，盲袢埋置皮下，再做胆肠Roux-en-Y吻合，病肝做规则性肝部分切除术。

Methods: Between November 2003 and December 2005, 67 patients with renal cell carcinoma underwent retroperitoneal laparoscopic radical nephrectomy (34 patients, group A) and open radical nephrectomy (33 patients, group B). Operating time, blond loss, amount of postoperative drainage, time to ambulation, recovery of intestinal function after operation, the postoperative hospital stay, use of antalgesic and transfusion blood and plasma were compared between group A and group B, retrospectively. Results: In group A, the operations of 31 patients were successful and 3 cases failed, then conversed to open surgery. Firstly, one case were not decented the prerenal fascia and the other two cases occurred complications, one case was due to injurying genital gland vein, with blood loss of 500m1, another fatty renal capsula was too thick to explose the renal pedicle. The operations of group B were all successful, only one case was died of intracerebral hemorrhage after two monthes.

回顾性分析和比较后腹腔镜肾癌根治性切除术(Retroperitoneal laparoscopic radical nephrectomy， RLRN)34例与开放性肾癌根治性切除术(Open radical nephrectomy， ORN)33例，比较两种方法的手术时间、术中出血、术后引流、术后最早下床活动时间、肠功能恢复情况、术后住院时间、术后镇痛剂使用量、术中术后输血、血浆量、术后随访时间及手术效果结果：A组中1例因最初对解剖结构难于辨认，无法分离肾前筋膜至肾门而改行开放手术，1例因损伤精索静脉出血难以控制而改行开放手术，1例因肾周脂肪过多，无法将肾脏掀起显露肾蒂而行开放手术，31例手术成功。B组手术均获成功，1例术后2个月因大面积脑出血死亡，余均无瘤生存。

Travel is pure appendix excises 9, celiac lens appendix excises 1, caecal ileum excises 2, right half colonic cancer effects a radical cure art 1, rectum...

行单纯阑尾切除9例，腹腔镜阑尾切除1例，盲肠回肠切除2例，右半结肠癌根治术1例，直肠。。。

Objective Toevaluate the technical feasibility and clinical efficacy of retroperitoneoscopic subcapsular nephrectomy for infective non-functioning kidney with dense perinephric adhesion.

肾切除术。观察手术时间、术中出血量、术后肠功能恢复和术中、术后并发症及手术效果。

Results In group A, 5 cases underwent elective colectomy. Half year after operation, 3 cases with normal defecation, 2 with constipations relapse. In group B, 8 cases underwent subtotal colectomy and partial rectectomy with cecorectal anastomosis. One with constipations relapse, other patients had 37 times of defecation per day after half year of operation.

结果 A组：采用选择性结肠肠段切除术治疗5例，术后半年内随访，3例大便正常，但有2例便秘复发。B组：采用结肠次全切除和部分直肠切除，行盲直肠吻合术治疗8例，有1例术后半年内便秘复发，其他患者术后半年内排便次数为3～7次/d。

Intra-operative polypectomy via endoscopy will reduce the risk of repeated bowel resections and malignancy.

术中和围手术期内镜下息肉切除术可以降低反复肠切除和息肉恶性变所致风险。

The ultrastructure was observed by electrical microscope and the specimens were collected from bowel at pull-through operation on 4 HD patients.

对照组结肠取自结肠癌患者及肠套叠患儿行肠切除吻合术手术切除的标本，这些人均无先天性肠功能异常的病史，取标本中正常的组织作为正常对照。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。