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首页> 外文期刊>Surgical Endoscopy >Laparoscopically assisted intestinal resection in 88 patients with Crohn's disease.
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Laparoscopically assisted intestinal resection in 88 patients with Crohn's disease.

机译：腹腔镜辅助肠切除术治疗88例克罗恩病患者。

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BACKGROUND: Experience with 94 resections in 88 patients with Crohn's disease using advanced laparoscopic techniques is reported. Records of patients who underwent intestinal resection for Crohn's disease between August, 1993 and November, 1998 were reviewed. Indications, operative findings, clinicopathologic, and postoperative data were recorded. METHODS: In this study, the mean age was 37 years (range, 16-70 years), and 55% of the participants were women. Indications for surgery included obstruction (64 cases), pain (22 cases), peritonitis (1 case) and abscess (1 case). Seventy patients underwent ileocolic resection, 28 of whom had a previous history of one or two ileocolic resections. Eight of these patients had additional procedures including tubal ligation (1), sigmoidectomy (1), cholecystectomy (3 cases), and enterectomy (3 cases). Small bowel resection (13 cases), right hemicolectomy (3 cases), subtotal colectomy (3 cases), anterior rectal resection (2 cases), and sigmoid resection (3 cases) were performed in the remaining patients. All but one procedure were completed laparoscopically with extracorporeal anastomosis. The average length of intestine resected was 33 cm (range, 10-92 cm). Forty-one patients had 58 fistulae between ileum, jejunum, mesentery, colon, abdominal wall, skin, or bladder. Mean blood loss was 168 ml (range, 30-800 ml) and mean operative time was 183 min (range, 96-400 min). RESULTS: More than 85% of the patients were tolerating a liquid diet on the first postoperative day. Average length of hospital stay was 4.2 days (range, 3-11 days). Complications included anastomotic leak necessitating reoperation, stricture requiring endoscopic dilation, hemorrhage treated expectantly, urinary tract infection, pulmonary embolus, line sepsis, and early postoperative intestinal obstruction (7 cases) requiring reoperation in three cases. CONCLUSIONS: Experience with both advanced laparoscopic techniques and conventional surgery for inflammatory bowel disease allowed successful laparoscopic management of patients with complicated Crohn's disease.
机译：背景：报道了使用先进的腹腔镜技术对88例克罗恩病患者进行94次切除的经验。回顾了1993年8月至1998年11月间因克罗恩病进行肠切除的患者的记录。记录适应症，手术结果，临床病理和术后数据。方法：本研究的平均年龄为37岁（范围16-70岁），其中55％的参与者为女性。手术适应证包括阻塞（64例），疼痛（22例），腹膜炎（1例）和脓肿（1例）。 70例患者接受了回盲切除术，其中28例曾做过一两次回盲切除术。这些患者中有8例接受了其他手术，包括输卵管结扎术（1），乙状结肠切除术（1），胆囊切除术（3例）和肠切除术（3例）。其余患者均行小肠切除术（13例），右半结肠切除术（3例），大肠切除术（3例），直肠前切除术（2例）和乙状结肠切除术（3例）。除一项手术外，所有手术均在腹腔镜下完成体外吻合术。切除的肠平均长度为33厘米（范围为10-92厘米）。 41名患者在回肠，空肠，肠系膜，结肠，腹壁，皮肤或膀胱之间有58根瘘。平均失血量为168毫升（范围为30-800毫升），平均手术时间为183分钟（范围为96-400分钟）。结果：术后第一天，超过85％的患者耐受流质饮食。平均住院时间为4.2天（范围3-11天）。并发症包括需要再次手术的吻合口漏，需要内镜扩张的狭窄，预期治疗的出血，尿路感染，肺栓塞，败血症和术后早期肠梗阻（7例），需要再手术3例。结论：具有先进的腹腔镜技术和常规手术治疗炎症性肠病的经验使成功治疗复杂克罗恩病患者的腹腔镜成为可能。

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