切换至 "中华医学电子期刊资源库"
高级检索
中华腔镜外科杂志(电子版)

中华腔镜外科杂志(电子版) ›› 2020, Vol. 13 ›› Issue (01): 31 -35. doi: 10.3877/cma.j.issn.1674-6899.2020.01.008

所属专题： 文献资源库；

论著 上一篇    下一篇

腹腔镜手术在腹茧症治疗中的安全性及可行性研究
段衍涛 1, 黄雨桦 1, 刘斌 1, 姚丹华 1, 郑磊 1, 周致圆 1, 王鹏飞 1, 李幼生 1 , †( )   
  1. 1. 200011 上海交通大学医学院附属第九人民医院普外科
  • 收稿日期:2019-12-10 出版日期:2020-02-28
  • 通信作者: 李幼生
  • 基金资助:
    国家自然科学基金(81802303); 浦东新区卫生和计划生育委员会卫生计生科研项目(PW2018D-01); 白求恩·爱惜康卓越外科基金(HZB-20181119-9)

Safety and feasibility of laparoscopic surgery in the treatment of abdominal cocoon syndrome

Yantao Duan 1, Yuhua Huang 1, Bin Liu 1, Danhua Yao 1, Lei Zheng 1, Zhiyuan Zhou 1, Pengfei Wang 1, yousheng Li 1 , †( )   

  1. 1. Department of General Surgery, Shanghai Ninth People′s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
  • Received:2019-12-10 Published:2020-02-28
  • Corresponding author: yousheng Li
  • About author:
    Corresponding author: Li Yousheng, Email:
全文 ( ) 下载PDF ( )
目的

探讨腹腔镜手术在腹茧症治疗中的安全性和有效性。

方法

回顾性分析2016年1月至2019年11月期间在上海交通大学医学院附属第九人民医院就诊共计13例接受外科手术的腹茧症患者的临床资料。

结果

13例患者的外科手术均顺利完成，其中8例腹腔镜手术、5例传统手术。所有患者因肠梗阻症状而就诊，均进行茧膜切除及肠粘连松解术。由于既往腹部手术史，5例采用传统手术方式。相较于传统手术，腹腔镜手术组的术中出血量减少[(116.3 ± 14.0)ml比(180.6 ± 24.9)ml，P< 0.05]，手术时间缩短[(99.3 ± 8.7)min比(130.6 ± 7.5)min，P<0.05]。腹腔镜组与传统手术组分别出现4例、3例术后并发症(P> 0.05)；术后肠梗阻分别3例、2例(P>0.05)；术后住院时间(11.4 ± 3.5)d和(13.4 ± 5.2)d(P> 0.05)。13例患者术后病理均提示纤维性包膜。

结论

腹腔镜手术对于既往无腹部手术史腹茧症治疗是安全、有效的。

关键词: 腹茧症, 腹腔镜手术, 剖腹探查术, 肠梗阻, 并发症
Objective

To analyze the safety and feasibility of laparoscopic surgery in the treatment of abdominal cocoon syndrome.

Methods

A retrospective analysis was performed on the clinical data of 13 patients with abdominal cocoon syndrome who underwent surgery at the department of general surgery in Shanghai Ninth People′s Hospital, Shanghai Jiaotong University School of Medicine from Jan. 2016 to Nov. 2019.

Results

13 patients successfully underwent the surgical treatment. 8 patients underwent laparoscopic surgery, and the other 5 patients were performed with conventional laparotomy. All the patients presented with clinical features of intestinal obstruction, and underwent membrane excision and enterodialysis to release the small intestine. Because of abdominal surgery history, 5 cases were finally approached by laparotomy. Laparoscopic surgery showed less blood loss [(116.3 ± 14.0 ) ml vs (180.6 ± 24.9) ml, P< 0.05] and shorter operative time [(99.3 ± 8.7) min vs (130.6 ± 7.5) ml, P< 0.05] compared with laparotomy. There were 4 cases and 3 cases with postoperative complications (P> 0.05), 3 cases and 2 cases with prolonged ileus (P> 0.05) in the laparoscopic group and the laparotomy group, respectively. The postoperative hospital stay was (11.4 ± 3.5) d and (13.4 ± 5.2) d (P> 0.05) of the laparoscopic and laparotomy group, respectively. The postoperative pathology of 13 patients showed fibrous envelope.

Conclusions

Laparoscopic surgery is a feasible and effective management in the treatment of abdominal cocoon syndrome without abdominal surgery history.

Key words: Abdominal cocoon syndrome, Laparoscopic surgery, Laparotomy, Intestinal obstruction, Complications
图1 腹茧症患者术前增强CT检查
表1 两组腹茧症患者的术前临床资料比较
组别 例数 性别(例，男/女) 年龄(岁， ±s) 体质量指数(kg/m2， ±s)
腹腔镜手术组 8 6/2 42.6 ± 4.6 18.7 ± 0.6
传统剖腹探查术组 5 3/2 44.2 ± 7.0 19.0 ± 0.7
P值 ? > 0.05 > 0.05 > 0.05
图2 腹腔镜手术的术中情况
表2 两组腹茧症患者的术中临床资料比较( ±s)
组别 例数 术中出血量(ml) 手术时间(min)
腹腔镜手术组 8 116.3 ± 14.0 99.3 ± 8.7
传统剖腹探查术组 5 180.6 ± 24.9 130.6 ± 7.5
P值 ? < 0.05 < 0.05
图3 剥离茧膜病理图片(HE染色，200倍)
表3 两组腹茧症患者的术后临床资料比较
组别 例数 并发症(例，有/无) 术后肠梗阻(例，有/无) 住院时间(d， ±s)
腹腔镜手术组 8 4/4 3/5 11.4 ± 3.5
传统剖腹探查术组 5 3/2 2/3 13.4 ± 5.2
P值 ? > 0.05 > 0.05 > 0.05
1
Foo KT, Ng KC, Rauff A，et al. Unusual small intestinal obstruction in adolescent girls: the abdominal cocoon [J]. Br J Surg, 1978, 65 (6):427-430.
2
Li S, Wang JJ, Hu WX，et al. Diagnosis and treatment of 26 cases of abdominal cocoon [J]. World J Surg, 2017, 41 (5):1287-1294.
3
Sharma D, Nair RP, Dani T，et al. Abdominal cocoon-a rare cause of intestinal obstruction [J]. Int J Surg Case Rep, 2013, 4 (11):955-957.
4
Tannoury JN, Abboud BN. Idiopathic sclerosing encapsulating peritonitis: abdominal cocoon [J]. World J Gastroenterol, 2012, 18 (17):1999-2004.
5
Clatworthy MR, Williams P, Watson CJ，et al. The calcified abdominal cocoon [J]. Lancet, 2008, 371 (9622):1452-1452.
6
Singh B, Gupta S. Abdominal cocoon: a case series [J]. Int J Surg, 2013, 11 (4):325-328.
7
Uzunoglu Y, Altintoprak F, Yalkin O，et al. Rare etiology of mechanical intestinal obstruction: abdominal cocoon syndrome [J]. World J Clin Cases, 2014, 2 (11):728-731.
8
Sartelli M, Chichom-Mefire A, Labricciosa FM，et al. The management of intra-abdominal infections from a global perspective: 2017 wses guidelines for management of intra-abdominal infections[J]. World Journal of Emergency Surgery, 2017, 12(1):29-29.
9
李正荣，冯宗峰. 腹茧症诊断与治疗的研究进展 [J]. 中华消化外科杂志，2018, 17 (9):910-913.
10
Li N, Zhu W, Li Y，et al. Surgical treatment and perioperative management of idiopathic abdominal cocoon: single-center review of 65 cases [J]. World J Surg, 2014, 38 (7):1860-1867.
11
Singhal M, Krishna S, Lal A，et al. Encapsulating peritoneal sclerosis: the abdominal cocoon [J]. Radiographics, 2019, 39 (1):62-77.
12
Sharma V, Mandavdhare HS, Rana SS，et al. Role of conservative management in tubercular abdominal cocoon: a case series [J]. Infection, 2017, 45 (5):601-606.
13
Fursevich D, Burt J. Abdominal cocoon syndrome: a rare cause for recurrent abdominal pain [J]. J Gastrointest Surg, 2017, 21 (7):1194-1195.
14
Jovani M, Baticci F, Bonifacio C，et al. Abdominal cocoon or idiopathic encapsulating peritoneal sclerosis: magnetic resonance imaging [J]. Dig Liver Dis, 2014, 46 (2):192-193.
15
Terebus Loock M, Lubrano J, Courivaud C，et al. CT in predicting abdominal cocoon in patients on peritoneal dialysis [J]. Clin Radiol, 2010, 65 (11):924-929.
16
Illan Riquelme A, Camacho Lozano J, Abdalahi H，et al. Abdominal cocoon: a rare cause of intestinal obstruction [J]. Cir Esp, 2016, 94 (7):417-419.
17
Singh H, Irrinki S, Yadav TD，et al. Surgical outcomes in patients with abdominal cocoon: series of 15 patients [J]. World J Surg, 2019, 43 (9):2143-2148.
18
刘荣. "预后控制"策略中的干预目标制订和干预时机选择[J/CD]. 中华腔镜外科杂志(电子版), 2019, 12 (1):28-30.
[1] 王伟, 王坤, 孙涛, 茹玉航, 刘晓. 血清肝素结合蛋白、C-反应蛋白和降钙素原对肺癌电视胸腔镜术后肺部细菌感染的预测价值[J]. 中华实验和临床感染病杂志(电子版), 2021, 15(04): 257-262.
[2] 李海寿, 尹林, 黄子健, 韦合雷, 莫毓. 胰十二指肠切除术中两种胰肠吻合方式的临床对比研究[J]. 中华普外科手术学杂志(电子版), 2021, 15(04): 396-399.
[3] 邵得志, 冯志毅, 郭乃超, 吕衍霖, 王晓翠, 董宇豪. 急性非结石性胆囊炎42例诊治分析[J]. 中华普外科手术学杂志(电子版), 2021, 15(04): 434-436.
[4] 陈家先, 宋春, 段春宁, 孙建伟. 内镜下难治性胆总管结石行ERCP取石的安全性研究[J]. 中华普外科手术学杂志(电子版), 2021, 15(04): 437-439.
[5] 朱蜀侠, 李康, 王宇, 袁丹, 刘东亮. 输尿管软镜钬激光碎石术后肾包膜下血肿三例报告并文献复习[J]. 中华腔镜泌尿外科杂志(电子版), 2021, 15(04): 347-351.
[6] 金曜, 徐继宗, 杨帆, 张弦. 开放腹壁疝网片修补术早期并发症的影响因素分析[J]. 中华疝和腹壁外科杂志(电子版), 2021, 15(04): 398-400.
[7] 陈华萍, 甘志新, 刘刚, 刘双林, 刘禹, 焦玉丁, 缪殿南, 徐静, 王关嵩, 徐智, 李琦, 胡明冬. 慢性阻塞性肺疾病的合并症/并发症的发病率和病死率分析[J]. 中华肺部疾病杂志(电子版), 2021, 14(04): 417-421.
[8] 陈波, 张科, 于明帅, 马荷荷. 腹部手术患者术后肺部并发症风险预测模型构建[J]. 中华肺部疾病杂志(电子版), 2021, 14(04): 502-504.
[9] 邓俊晖, 肖凯华, 陈志玉, 黄稳达, 杨家君, 黄玉宝, 黄学军. 吻合器部分痔环切钉合联合选择性内痔缝扎术治疗环状痔的可行性和疗效[J]. 中华结直肠疾病电子杂志, 2021, 10(04): 413-417.
[10] 张童童, 于溯洋, 周瑾, 赵士彭. 先天性腹茧症伴肠发育不良、大网膜缺如一例报告并文献学习[J]. 中华结直肠疾病电子杂志, 2021, 10(04): 424-426.
[11] 闫顺笠, 孙慧敏, 郑朝旭, 刘正, 陈海鹏, 关旭, 庄孟, 黄海洋, 王锡山, 裴炜. 全腹腔镜右半结肠癌根治术后肠梗阻一例并文献复习[J]. 中华结直肠疾病电子杂志, 2021, 10(04): 427-431.
[12] 曾维根, 韩加刚, 庞国义, 赵琦, 赵宝成, 王振军. 肠造口后择期手术对比支架置入后择期手术治疗梗阻性左半结肠癌的效果分析[J]. 中华结直肠疾病电子杂志, 2021, 10(04): 362-366.
[13] 李明东, 谢红强, 陶涛, 朱萧. 结直肠癌患者术后肠梗阻发生风险列线图预测模型的构建及评估[J]. 中华消化病与影像杂志(电子版), 2021, 11(04): 158-163.
[14] 蓝炘, 朴成林, 安峰铎, 谈明坤, 司振铎, 吴蔚, 赵娜, 冷建军. 3D腹腔镜与2D腹腔镜下肝癌切除术的短期疗效比较[J]. 中华临床医师杂志(电子版), 2021, 15(05): 327-330.
[15] 周君, 石星原, 张庆玲, 刘向辉, 郭运林, 张之营, 张建. 颅骨修补术后癫痫发作的预后分析[J]. 中华临床医师杂志(电子版), 2021, 15(05): 356-359.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号