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白内障超声乳化术中转换术式的原因探讨

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临床眼科杂志 2003年第3期11卷 281-282页

作者：刘秀伦吕志刚浙江省金华市中心医院眼科 321000

目的　探讨白内障超声乳化术中转换术式原因。方法　对 982只眼白内障超声乳化术进行回顾性研究 ,其中 2 6只眼转换术式。结果　高度近视 8只眼、级核 6只眼、外伤性白内障 6只眼、玻璃体切除术后 3只眼、马凡综合征 1只眼。结论　后... 详细信息

目的　探讨白内障超声乳化术中转换术式原因。方法　对 982只眼白内障超声乳化术进行回顾性研究 ,其中 2 6只眼转换术式。结果　高度近视 8只眼、级核 6只眼、外伤性白内障 6只眼、玻璃体切除术后 3只眼、马凡综合征 1只眼。结论　后囊膜破裂与硬核是术式转换的主要原因。

关键词：白内障超声乳化术术式转换原因后囊膜破裂硬核

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腹腔镜下结肠直肠外科术式转变的后果

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世界核心医学期刊文摘（胃肠病学分册） 2006年第8期2卷 9-10页

作者： Gonzalez R. Smith C. D. Mason E. B.J. Ramshaw 纪泛扑(译) 史敏(校) 不详 MC44 McHaney Hall One Hospital Drive Columbia MO 65212 United States

INTRODUCTION: Laparoscopic procedures converted to open approaches have been associated with higher complication rates than laparoscopic and open cholecystectomy and appendectomy. Laparoscopic colorectal resections have relatively high conversion rates compared with other laparoscopic procedures. This study was designed to evaluate outcomes of conversions compared with laparoscopic and open colorectal resections. METHODS: We reviewed 498 consecutive colorectal resections performed between 1995 and 2002. Procedures were divided into laparoscopic colorectal resections, open colorectal resections, or conversions. Demographics, underlying disease, type of procedure performed, and operative outcomes were compared between groups. RESULTS: Of the 238 laparoscopic procedures performed, 182 were completed laparoscopically and 56 (23 percent) required conversion; 260 were performed open. Conversions were associated with greater blood loss (200 (range, 50- 750) vs. 100 (range, 30- 900) ml), longer time to first bowel movement (82 (range, 40- 504) vs. 72 (range, 12- 420) hr), and longer length of stay (6 (range, 2- 67) vs. 5 (range, 2- 62) days) than the laparoscopic colorectal resections group. There was no difference in operative time, transfusion requirements, intraoperative and postoperative complications, or mortality between conversions and laparoscopic colorectal resections. Conversions resulted in fewer patients requiring transfusions (4 vs. 14 percent), shorter time to first bowel movement (82 (range, 40- 504) vs. 93 (range, 24- 240) hr), and shorter length of stay (6 (range, 2- 67) vs. 7 (range, - 180) days) than in the open colorectal resections group. There were no differences in complications or mortality between the conversion group and the open colorectal resections group. CONCLUSIONS: Laparoscopic colorectal resections has a relatively high conversion rate; however, the converted cases have outcomes similar to open colorectal resections. In fact, the converted g

关键词：结肠直肠切除术腹腔镜下外科术式腹腔镜胆囊切除术腹腔镜手术开腹胆囊切除术术式转换阑尾切除术开腹手术手术方式

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Ⅳ期结肠直肠癌进行姑息性腹腔镜切除术

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世界核心医学期刊文摘（胃肠病学分册） 2006年第8期2卷 11-12页

作者： Moloo H. Bédard E. L. R. Poulin E. C. C.M. Schlachta 纪泛扑(译) 史敏(校) 不详 CSTAR (Canadian Surgical Technologies and Advanced Robotics) London Health Sciences Centre 339 Windermere Road London. Ont. N6A 5A5 Canada

PURPOSE: Issues surrounding the safety and efficacy of palliative laparoscopic resections for patients with Stage IV colorectal cancer have not been explicitly examined in the literature. This article describes our experience with laparoscopic procedures for patients with Stage IV colorectal cancer and compares thir perioperative outcomes to a contemporaneous group of patients with clinically curable (Stages I- III) disease. METHODS: A prospective database of laparoscopic resections for colorectal cancer performed between 1991 and 2002 was reviewed. Data regarding patient demographics, perioperative morbidity and mortality, operative times, conversion rates, and length of stay were extracted. Statistical analysis included chi-squared and Student s t-tests as required and P ≤ 0.05 was considered significant. RESULTS: A total of 375 cases were identified, of these 49 (13 percent) underwent laparoscopic palliative resections while 326 (87 percent) patients had resections for cure. When comparing palliative to curative procedures, there were no differences in intraoperative (4 percent vs. 9 percent) or postoperative complications (14 percent vs. 12 percent), perioperative mortality (8 percent vs. 4 percent), or length of hospital stay. Patients with Stage IV disease had larger tumors (5.4 ± 2.3 cm vs. 4.6 ± 2.6 cm, P = 0.04) which contributed to an increased rate of conversion (22 percent vs. 11 percent, P = 0.05) with most conversions secondary to tumor fixation or bulk (64 percent) preventing determination of resectability. CONCLUSIONS: A palliative laparoscopic resection is a safe and feasible option and presents acceptable morbidity and mortality in patients with Stage IV colorectal cancer. Importantly, in this difficult group of patients, our results compare favorably with those from previously published series of open procedu res.

关键词：腹腔镜切除术结肠直肠癌姑息性 Ⅳ期直肠癌患者治愈性切除术腹腔镜手术治疗人口统计学手术期间术式转换