RESUMO
Objective To compare the clinical efficiency between laparoscopic enterodialysis and open enterodialysis. Methods Clinical data of 25 cases of adhesive intestinal obstruction treated by laparoscopic enterodialysis (Laparoscopic Group) from December 1999 to December 2002 were retrospectively reviewed and compared with clinical records of 23 cases receiving open enterodialysis (Open Group) in the same period. The operating time, intra-operative blood loss, incidence of complications, postoperative recovery time of bowel movement and length of hospital stay of the two groups were compared, respectively. Results In the Laparoscopic Group operation was successfully accomplished in 23 cases while a conversion to open surgery was required in 2 cases. Of the Laparoscopic Group and the Open Group, the operation time was (58.3?8.1) min and (84.0?7.5) min (t=11.383, P=0.000), respectively; the intra-operative blood loss was (31.4?5.1) ml and (192.6?26.4) ml (t=29.995, P=0.000), respectively; the postoperative hospital stay was (4.1?1.4) days and (9.7?2.0) days (t=11.413, P=0.000), respectively; the postoperative recovery time of bowel function was (19.6?2.2) hours and (49.0?8.8) hours (t=16.207, P=0.000), respectively and the postoperative complications were seen in 1 case and 9 cases (?2=6.960, P=0.008), respectively. Conclusions Compared with open enterodialysis, laparoscopic enterodialysis has advantages of short operation time, less blood loss, rapid recovery and fewer complications.
RESUMO
Objective To evaluate changes of venous hemodynamics during laparoscopic cholecystectomy(LC).Methods A total of 25 cases of LC was included in the study.A Doppler ultrasonography of the lower limb veins was performed in all the patients to exclude those with abnormal veins or thrombosis.During the LC,the diameter and venous flow volume of the femoral vein were measured under Doppler ultrasonography.Measurements were obtained at three different times:after the induction of anesthesia but prior to the creation of the pneumoperitoneum,during the pneumoperitoneum,and after abdominal deflation but prior to the reversal of anesthesia.Results All the operations were successfully completed.The mean operation time was 45 min(range,30～70 min).No intraoperative hemorrhage or bile duct complications occurred.No conversion to open surgery was required.All the patients were dismissed from hospital on the first postoperative day.After the establishment of the pneumoperitoneum,the cross-sectional area of the femoral vein was increased from 0.94?0.18 cm2 to 1.12?0.23 cm2(q=3.919,P0.05).The venous flow was significantly increased from 7.62?0.72 cm3/s to 9.65?0.63 cm3/s(q=12.971,P