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首页> 外文期刊>Updates in Surgery >Early results and complications of colorectal laparoscopic surgery and analysis of risk factors in 492 operated cases
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Early results and complications of colorectal laparoscopic surgery and analysis of risk factors in 492 operated cases

机译：492例大肠腹腔镜手术的早期结果，并发症及危险因素分析

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This study aimed to evaluate the early results of colorectal laparoscopic surgery with special attention to surgical and medical complications. The risk factors of such surgery are also investigated on the basis of a large series of operated cases: the preoperative knowledge of such factors could guide the operative program and the postoperative treatment with reduction of complications and improvement of the outcome. Between 1998 and 2008, 492 patients had been submitted to colorectal laparoscopic surgery by the same team: 387 for cancer and 105 for benign disease. All colorectal surgical operations are included in the series. No selection of the patients was made: laparoscopy was performed in all cases accepting the procedure. Several risk factors have been analysed in cases of fistula (age, pathology sex, type of the operation, cancer stages, preoperative radiochemotherapy, stool diversion and team experience) and in cases of medical complications (age, pathology, cancer stages and type of operation). The overall results in this series of laparoscopic colorectal operated cases are similar to other results published at present by the main surgical Department all over the world; no mortality and low number of medical (2.4%) and surgical complications (9.3%), with no differences also with the best open surgery series. Complete or partial conversion to open surgery was required in few cases (1.2%) and same others (1.4%) were operated again for bleeding or sudden anastomotic leakage. Regarding the risk factors in such surgery, a good correlation has been discovered between anastomotic leakage and the team experience, the age over 70 of the patients, the rectal tumour site in man, the advanced tumour stages, the previous radiochemotherapy, while medical complications seem to depend on advanced patients age and advanced cancer stages. Laparoscopic colorectal surgery at present is going to be considered the gold standard in the large majority of colorectal diseases including all cancer stages in the preoperative balance and in the early postoperative follow-up a special attention is required to same risk factors like the advanced patients age, the extended cancers, the low positioned rectal tumours. Complications are more frequent at the beginning of the experience of the surgical team and if more than one risk factors coexist, but it do not represent contraindication to laparoscopic surgery.
机译：这项研究旨在评估大肠腹腔镜手术的早期结果，并特别注意手术和医学并发症。还根据一系列手术病例研究了此类手术的危险因素：术前了解这些因素可指导手术程序和术后治疗，减少并发症并改善结局。在1998年至2008年之间，同一团队已对492例患者进行了大肠腹腔镜手术：癌症387例，良性疾病105例。该系列包括所有结直肠外科手术。没有选择患者：所有接受手术的病例均进行腹腔镜检查。已对瘘管病例（年龄，病理性别，手术类型，癌症分期，术前放化疗，粪便转移和团队经验）和医疗并发症病例（年龄，病理学，癌症分期和手术类型）分析了几种危险因素）。该系列腹腔镜结直肠癌手术病例的总体结果与全球主要外科部门目前发表的其他结果相似；无死亡率，医疗（2.4％）和手术并发症（9.3％）的发生率低，最好的开放式手术系列也无差异。在少数情况下（1.2％）需要完全或部分转换为开放手术，而对于其他情况（1.3％），由于出血或突然的吻合口漏血，需要再次手术。关于此类手术的危险因素，已发现吻合口漏与团队经验，70岁以上的患者，男性的直肠肿瘤部位，晚期肿瘤分期，先前的放射化学疗法以及医疗并发症之间存在良好的相关性。取决于晚期患者的年龄和晚期癌症阶段。目前，腹腔镜结直肠癌手术被认为是绝大多数结直肠疾病（包括术前平衡阶段所有癌症阶段）的金标准，在术后早期随访中，需要特别注意与高龄患者年龄相同的危险因素，扩展的癌症，低位的直肠肿瘤。并发症在手术团队刚开始时更为频繁，并且如果存在多种危险因素，但这并不代表腹腔镜手术的禁忌症。

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