CLINICAL AND EXPERIMENTAL STUDY ABOUT THE LAPAROSCOPIC THERAPY FOR ADHESIVE ILEUS

腹腔镜治疗粘连性肠梗阻的临床与实验研究

基本信息

批准号：
06671256
负责人：
NAKAGAWA Takao
金额：
$ 0.7万
依托单位：
Fukui MEDICAL SCHOOL
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1994
资助国家：
日本
起止时间：
1994 至 1995
项目状态：
已结题

项目摘要

The present study was made to establish laparoscopic adhesiolysis procedural approach to adhesive ileus. Procedural problems represent complication of 1) intestinal contused laceration with intestinal grasping forceps and 2) intestinal damage on adhensiolysis, each. For the solution of 1), we devised such an intestinal grasping forces as is designed not to increase above a definite pressure the pressure of the above forceps-adjusting handle at hand, and this made it possible to prevent contused laceration or supertraction of the intestinal wall. For the solution of 2), which is most important for establishing the laparoscopie adhensiolysis procedure, we examined its solution approach from its clinical results. We have so far tried the laparoscopie adhensiolysis on 17 cases of adhesive ileus, 6 of which succeeded in adhensiolysis not with intestinal grasping forceps but with electric knife or scissors under laparoscopic observation. Of 11 cases of adhensiolysis with electric knife or sc … More issors under intestinal traction with intestinal grasping forceps, 4 (36.4%) presented intestinal perforations under adhensiolysis. Any one of the above perforations required perforation repair via small laparotomy following the completion of adhensiolysis. The postoperative course was favorable in all cases without recurrence of ileus so far. The above clinical results led to the conclusion that the intestinal perforation under adhensiolysis may be ascribable greatly to the use of intestinal grasping forceps and that good operative results may be obtained through several cm small laparotomy for the intestinal perforation. Therefore, judging from the fact that experimental measurement of the influence of electric knife or scissors on the tracted intestinal canal has a little interest for establishing laparoscopie adhensiolysis procedure, the experimental design was stopped. In view of our experience in using the needle type laparoscopy of 3 mm in extemal diameter now under development by Olympus Co., Ltd., the laparoscopic adhensiolysis using this needle type laparoscopy was thought to be not only very easy procedurally and less invasive compared with standard type laparoscopy, but also useful for the improvement in safety. Less

本研究是为了建立腹腔镜粘合剂的粘合剂卵巢方法。程序问题代表1）肠道束缚的并发症的并发症，肠道抓紧力和2）肠道损伤对粘合力。对于1）的溶液，我们设计了一种肠道抓握力，旨在不增加上述镊子调整手柄的压力，这使得可以防止肠壁的污损或超级牵引力。对于2）的解决方案，这对于建立腹腔镜广告分解程序最重要，我们从临床结果中检查了其解决方案方法。到目前为止，我们已经尝试了17例粘合剂的腹腔镜广告分解，其中6例在粘合剂握把方面取得了成功，但在腹腔镜检查下进行了电刀或剪刀。在11例用电刀或SC的敏化溶液中，有更多的肠道牵引钳下的发病人，有4个（36.4％）在粘合剂下呈现肠穿孔。广告完成后，上述任何一种穿孔都需要通过小型剖腹手术进行穿孔修复。到目前为止，上述临床过程在所有情况下都没有复发。上述临床结果得出的结论是，粘合剂下的肠穿孔可能归因于使用肠道抓地力，并且可以通过几次CM小型腹腔切开式肠道穿孔获得良好的工作结果。因此，从对电刀或剪刀对肠道管道的影响的实验测量的判断，对建立腹腔镜广告溶解程序的兴趣不大，实验设计停止了。鉴于我们使用Olympus Co.，Ltd。开发的外径3毫米的针型腹腔镜检查的经验，使用这种针型腹腔镜的腹腔镜递增溶解症的经验不仅是非常容易的程序性，而且与标准类型的laparoscic相比，还对改进的安全性也很有用。较少的