...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >Laparoendoscopic single-site surgery is feasible in complex colorectal resections and could enable day case colectomy.
【24h】

Laparoendoscopic single-site surgery is feasible in complex colorectal resections and could enable day case colectomy.

机译：腹腔镜内镜下单部位手术在复杂的结直肠切除术中是可行的，并且可以进行日间结肠切除术。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: Fast-track surgery accelerates recovery, reduces morbidity, and shortens hospital stay. However, the benefits of laparoscopic versus open surgery remain unproven within a fast-track program. Case reports of laparoendoscopic single-site (LESS) colectomies are appearing with claims of cosmetic advantage and decreased parietal trauma. This report describes the largest case series of LESS colorectal surgery and its effects on recovery. METHODS: In this series, 20 consecutive unselected patients underwent LESS colorectal surgery including right hemicolectomy (n = 3), extended right hemicolectomy, high anterior resection (n = 2), low anterior resection involving total mesorectal excision (TME; n = 3), ileocolic anastomosis (n = 2, including 1 redo surgery), colectomy and ileorectal anastomosis (n = 4, including 1 with ventral mesh rectopexy), panproctocolectomy (n = 2), proctocolectomy and ileoanal pouch (n = 2) and an abdominoperineal excision of rectum. Single-port conventional instrumentation and transversus abdominus plane (TAP) block analgesia were used. The indications included cancer (n = 8), Crohn's disease (n = 4), ulcerative colitis (n = 3) complicated diverticulosis (n = 2), and slow-transit constipation (n = 3). Eight of the patients had undergone previous surgery. RESULTS: Most of the cases (90%) were managed successfully using the LESS technique and conventional instrumentation. Two operations (10%) were converted to standard laparoscopy, due to insufficient theater time and an unstable port. The operative time ranged from 45 to 240 min (median, 110 min). A normal diet was tolerated within 6 h by 7 patients and in 12 to 16 h (overnight) by 11 patients. Complications included anastomotic bleed (n = 1), ileus (n = 2), acute renal failure secondary to hyperphosphatemia and hypocalcemia (n = 1), urine retention (n = 1), and wound infection (n = 1). The median hospital stay was 46 h (range, 7-384 h). Eight patients were discharged within 24 h. There was one readmission (5%). CONCLUSION: Laparoendoscopic single-site colorectal resection using conventional instrumentation is feasible and safe when performed by an experienced team. The LESS approach may have advantages in terms of minimal pain, cosmesis, lower costs, and faster recovery. A randomized trial is required to confirm whether LESS offers a true patient benefit over standard laparoscopic resection.
机译：背景：快速通道手术可加快康复速度，降低发病率，并缩短住院时间。但是，在快速通道计划中，腹腔镜手术与开放式手术相比的优势尚未得到证实。腹腔镜单部位（LESS）鞘膜切除术的病例报告出现，声称具有美容优势并减少了顶壁创伤。本报告介绍了LESS结直肠手术的最大案例系列及其对恢复的影响。方法：在该系列中，连续20例未选择的患者接受了LESS结直肠手术，包括右半结肠切除术（n = 3），大面积右半结肠切除术，高位前切除术（n = 2），低位前切除术（包括全直肠系膜切除术（TME; n = 3）） ，回肠结肠吻合术（n = 2，包括1次重做手术），结肠切除术和回肠直肠吻合术（n = 4，包括1个腹侧网状造血术），大肠结肠切除术（n = 2），结肠直肠切除术和回肠囊（n = 2）和腹部手术直肠切除。使用单端口常规器械和腹横肌平面（TAP）阻滞镇痛。适应症包括癌症（n = 8），克罗恩病（n = 4），溃疡性结肠炎（n = 3）并发憩室病（n = 2）和慢速便秘（n = 3）。其中八名患者曾经接受过手术。结果：大多数病例（90％）使用LESS技术和常规仪器成功治疗。由于手术时间不足和端口不稳定，两项手术（10％）被转换为标准腹腔镜检查。手术时间为45至240分钟（中位数为110分钟）。 7名患者在6小时内可以忍受正常饮食，而11名患者在12至16小时（过夜）可以忍受正常饮食。并发症包括吻合口出血（n = 1），肠梗阻（n = 2），继发于高磷血症和低钙血症的急性肾衰竭（n = 1），尿retention留（n = 1）和伤口感染（n = 1）。中位住院时间为46小时（范围7-384小时）。 8名患者在24小时内出院。再次入院（5％）。结论：由经验丰富的团队进行腹腔镜内镜下单部位结直肠癌切除术是可行且安全的。 LESS方法在最大程度减少痛苦，美容，降低成本和恢复更快方面可能具有优势。需要一项随机试验来确认LESS是否比标准腹腔镜切除术对患者真正有益。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号