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首页> 外文期刊>Surgical Endoscopy >Transanal hybrid colon resection: from laparoscopy to NOTES.
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Transanal hybrid colon resection: from laparoscopy to NOTES.

机译：Transanal Hybrid结肠切除术：从腹腔镜检查到笔记。

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摘要

Reducing access size and trauma are important issues in natural orifice transluminal endoscopic surgery (NOTES). The combination of experience with laparoscopic colorectal surgery and transanal endoscopic microsurgery has helped in the use of the transanal approach as a realistic option of NOTES techniques to introduce transanal hybrid laparoscopic-assisted colon resection into clinical practice. The purpose of this study was to assess the clinical introduction of transanal hybrid colon resection in terms of feasibility and patient safety.Patients with pelvic floor disorders, prolapse, and slow-transit constipation in whom a colon resection was indicated were recruited. Patients were followed prospectively with a postoperative well-being score, a pain score, and a quality-of-life score. All complications were prospectively documented. The essential change was the reduction of the number and size of ports by using the transanal route. A camera and two 5-mm ports for grasping forceps and delivering ultrasonic energy were the laparoscopic components. All tasks requiring a port diameter of >5 mm were applied via the transanal route, such as positioning of the proximal stapler anvil, application of linear stapling for resection, specimen retrieval, stapler anastomosis, and closing the bowel.Fifteen patients with benign colorectal disease underwent transanal hybrid colon resection, and 11 had additional rectopexy. All patients were women with a mean age of 61 (range, 28-86) years and a body mass index of 26 kg/m(2). One patient was converted to full laparoscopy. One complication--bleeding that required no reintervention--was recorded. The procedure lasted a mean of 131 (range, 55-184) min. The Gastrointestinal Quality of Life Index was 96 before surgery and 117 after surgery.From this initial experience, transanal hybrid colon resection seems a feasible and safe hybrid NOTES procedure that can be usefully introduced into clinical practice.
机译：减少访问尺寸和创伤是天然孔口外镜外科手术（笔记）的重要问题。腹腔镜结肠直肠手术和大天然内窥镜显微外科的经验的组合有助于使用常规方法作为注意技术的现实选择，以将常规杂交腹腔镜辅助结肠切除术引入临床实践中。本研究的目的是评估在可行性和患者安全方面的常规杂交结肠切除术的临床引入。招募了盆腔楼面疾病，脱垂和慢速过境便秘的患者被招募出结肠切除术。患者术后术后得分，疼痛评分和生活质量得分。所有并发症都在前瞻性地记录了。基本变化是通过使用横向路线减少端口的数量和大小。相机和两个5毫米端口用于抓握镊子并提供超声波能量是腹腔镜组分。通过常规路线施加需要港口直径> 5mm的所有任务，例如近端订书机砧座的定位，用于切除的线性装订，试样检索，订书机吻合术，并关闭肠道患者良性结直肠癌经过常规杂交结肠切除术，11例含有额外的矫直。所有患者均为平均年龄为61（范围，28-86）岁的女性，身体质量指数为26kg / m（2）。一名患者被转化为全腹腔镜检查。一个并发症 - 记录了无需重新入住的并发症。该程序持续了131（范围，55-184）分钟的平均值。手术前的胃肠道质量为96次手术前和117次手术后。通过这种初步的经验，TransAnal Hybrid Colon切除似乎是可以有效地引入临床实践中的可行和安全的混合注意事项。

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