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李长东,冯颖,陈素文,聂东云,李坚,张为远
《中国工程科学》 2014年 第16卷 第5期 页码 20-23
为了探讨宫腔镜和腹腔镜手术治疗剖宫产瘢痕妊娠（CSP）的指证及技术要点。回顾性地分析了首都医科大学附属北京妇产医院2013 年1 月—2013 年12 月收治的72 例CSP患者的治疗情况。所有患者入院后行血清人绒毛膜促性腺激素（HCG）测定和三维彩超检查。根据局部病灶范围、HCG结果和多普勒B超血流结果，术前选择性行子宫动脉栓塞介入治疗或甲氨蝶呤治疗后，进一步行宫腔镜、腹腔镜或宫腹联合手术治疗。结果显示，30 例采用超声监测下宫腔镜CSP病灶切除术，12 例采用腹腔镜监护下宫腔镜CSP病灶切除术，30 例采用宫腹腔镜联合CSP病灶切除+剖宫产瘢痕修补术，均收到了良好的治疗效果。术中出血量为（83±57）mL，术后肛门排气时间为（20±6.6）h，阴道流血时间为（3.2±4.8）d，血清HCG降至正常时间为（8.6±3.9）d，出院时间为（3.2±2.0）d。患者术后病理诊断与术前的CSP诊断符合率达到100 %。研究得出，有剖宫产史的妇女再次妊娠时，有发生CSP的可能。超声或腹腔镜监护下宫腔镜CSP病灶切除术是治疗CSP的有效措施，病灶切除确切，创伤小；宫、腹腔镜CSP病灶切除+剖宫产瘢痕修补术在切除病灶，对后续有生育要求患者同时修复剖宫产瘢痕处解剖学异常，降低了再次妊娠时CSP和子宫破裂、胎盘植入等产科并发症的风险。
Fertility outcome analysis after modified laparoscopic microsurgical tubal anastomosis
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《医学前沿（英文）》 2011年 第5卷 第3期 页码 310-314 doi: 10.1007/s11684-011-0152-8
Modified laparoscopic microsurgical tubal anastomosis is an alternative for microsurgical anastomosis via laparotomy to reverse sterilization in women with renewed child wish. The current study aims to evaluate the fertility outcome after modified laparoscopic microsurgical tubal anastomosis. A retrospective study was performed. Fifty-eight women who underwent modified laparoscopic microsurgical tubal anastomosis were monitored to investigate the fertility outcome and characteristics of this new technology. Of the 58 patients, the cumulative pregnancy rate (PR) in the 42 patients with follow-up data was 23.8% (10/42), 57.1% (24/42), 66.7% (28/42), and 73.8% (31/42) within 6, 12, 24, and 36 months after surgery, respectively. The intrauterine PR was 69.0% (29/42). Two patients (4.8%) had ectopic pregnancies that occurred within 24 months of surgery; three cases ended in spontaneous abortion. The delivery rate was 83.9% (26/31). The length of operating time was 1.2±0.3 h, with a range of 1.0–2.5 h (60–145 min), and the mean time was approximately 75 min. The blood loss was relatively small, between 10 and 50 ml with an average amount of 22 ml. Thus, the modified laparoscopic tubal anastomosis is a highly successful procedure and a viable alternative to open abdominal microsurgical approaches. Compared with the traditional laparoscopic tubal sterilization reversal, this modified approach has three advantages: (1) less invasive approach via a trocar reduction; (2) remodeling of tube is better performing tied together after 3–4 sutures; and (3) faster operating time.
Current progress on natural orifice transluminal endoscopic surgery (NOTES)
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《医学前沿（英文）》 2012年 第6卷 第2期 页码 187-194 doi: 10.1007/s11684-012-0198-2
Natural orifice transluminal endoscopic surgery (NOTES) has received considerable interest in recent years as a novel surgical technique. Here, we aim to review the current progress on NOTES, particularly focusing on the advantages and complications related to NOTES, the recent advances of surgical approaches, new instruments for closure of the natural orifice incision, and the newly developed platform for NOTES. Finally, we make a prediction of the conceivable applications of NOTES on human subjects.
关键词： natural orifice transluminal endoscopic surgery (NOTES) laparotomy laparoscopy
Strategies of minimally invasive treatment for intrahepatic and extrahepatic bile duct stones
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《医学前沿（英文）》 2017年 第11卷 第4期 页码 576-589 doi: 10.1007/s11684-017-0536-5
Cholelithiasis is a kind of common and multiple diseases. In recent years, traditional laparotomy has been challenged by a minimally invasive surgery. Through literature review, the therapeutic method, effect, and complications of minimally invasive treatment of intrahepatic and extrahepatic bile duct stones by combining our practical experience were summarized as follows. (1) For intrahepatic bile duct stones, the operation may be selected by laparoscopic liver resection, laparoscopic common bile duct exploration (LCBDE), or percutaneous transhepatic cholangioscopy. (2) For concomitant gallstones and common bile duct stones, the surgical approach can be selected as follows: laparoscopic cholecystectomy (LC) combined with endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilatation, LC plus laparoscopic transcystic common bile duct exploration, LC plus LCBDE, and T-tube drainage or primary suture. (3) For concomitant intrahepatic and extrahepatic bile duct stones, laparoscopic liver resection, choledochoscopy through the hepatic duct orifice on the hepatectomy cross section, LCBDE, EST, and percutaneous transhepatic cholangioscopic lithotripsy could be used. According to the abovementioned principle, the minimally invasive treatment approach combined with the surgical technique and equipment condition will be significant in improving the therapeutic effect and avoiding the postoperative complications or hidden dangers of intrahepatic and extrahepatic bile duct stones.
关键词： laparoscopy choledochoscopy duodenoscopy cholelithiasis minimally invasive treatment
Laparoscopic sigmoid vaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser syndrome
Yi SHEN MD , Guobin WANG MD , Zhoufang XIONG MD , Kaixiong TAO MD , Zehua WANG MD ,
《医学前沿（英文）》 2009年 第3卷 第3期 页码 347-351 doi: 10.1007/s11684-009-0059-9
关键词： Mayer-Rokitansky-Kuster-Hauser syndrome laparoscopy sigmoid transplantation vaginoagenesis
标题 作者 时间 类型 操作
Strategies of minimally invasive treatment for intrahepatic and extrahepatic bile duct stones
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