[Dissected bone and cysts of the trochlea tali (author's transl)].
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The results of 50 laparoscopic transabdominal pre-peritoneal inguinal hernia repairs are reported with a follow-up of 1-4 years. The patientsage range was 16-75 years. Two recurrences occurred. Only few complications were encountered. The procedure was remarkably pain-free, with 18% requiring no analgesia after the operation and 63% requiring no analgesia after discharge from hospital. There was a rapid return to normal activity, with 55% driving within I week of the operation and 84% within 2 weeks. Sixty-three per cent returned to work within 2 weeks of the operation and 71% within 3 weeks. The results show that laparoscopic hernia repair is remarkably pain-free, allows a rapid return to normal activity and has a low recurrence rate.
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Diverticulitis
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Background: Appendicitis is the most common cause of acute abdomen and appendectomy is the most frequent surgical procedure performed in the world in recent times.In the last few years the number of laparoscopic appendectomies performed around the world has dramatically increased.Objective: The aim of the work is to study the acceptance and satisfaction of the patients as regards the laparoscopic approach for management of acute appendicitis and evaluation the results.Patients and methods: It was a comparative study included 100 consecutive patients with acute appendicitis.They were given the options to accept the approach for appendectomy whether open or laparoscopic after discussion the advantages and disadvantages of each approach and the last decision were left to the patient.The study was approved by the medical ethics committee of Aswan University Hospital and a written informed consent was obtained from all patients.Results: The consecutive patients of age ranging from 15-45 years with features suggestive of acute appendicitis were divided into laparoscopic appendectomy group (LA) 70 cases and open appendectomy group (OA) 30 cases, after taking informed consent.LA was done with the help of three trocar/cannulae creating pneumoperitoneum with CO2 whereas OA was performed by McBurney incision.The operating times in OA and LA were 20-70 minutes (mean 30) and 25-95 minutes (mean 55) respectively.Increased doses of analgesics, antibiotics and antiemetics were required in OA, as compared to LA.The mean postoperative hospital stay in LA group was 1.4 days (range 1-3 days) whereas it was in OA group, it was 3.5 days (range 2-6 days).Conclusion: LA is safe and has major benefits like less postoperative pain, decreased wound infection, early hospital discharged, early return to work and a better cosmetic scar than OA.
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目的:探讨县级医院开展腹腔镜胆囊切除术(LC)的方法和经验.方法:回顾分析某医院194例胆囊结石行LC的临床资料,其中慢性胆囊炎胆囊结石168例、胆囊息肉6例、急性胆囊炎胆囊结石20例.结果:经LC治愈186例,平均住院时间5.2天.中转开腹8例,其中1例高位胆管损伤转安医大手术治愈,胆囊癌1例、胆囊床出血1例、胆囊十二指肠内漏1例、胆囊三角区粘连局部解剖不清4例经开腹手术治愈.手术并发症6例.结论:县级基层医院开展LC手术应分阶段,根据手术医生技术熟练程度严格掌握适应证,逐步扩大适应证,对于存在危险因素的患者应及时选择开腹手术,避免胆道损伤等严重并发症的发生.
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Diverticulitis
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Objective To explore the indication and regional condition of complicated laparoscopic cholecystectomy. Methods 246 complicated cases by laparoscopic cholecystectomy were analyzed retrospectively from July 2004 to December 2006. Results All cases were cured and four of them were operated as usual. Conclusion Almost all of the benign cholecystic disease can be performed by LC,but the cases with great difficulties should be operated routinely in time.
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Open surgery
Open cholecystectomy
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