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首页> 外文期刊>Surgical Endoscopy >Laparoscopic colorectal surgery: analysis of 140 cases.
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Laparoscopic colorectal surgery: analysis of 140 cases.

机译：腹腔镜大肠手术：分析140例。

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BACKGROUND: This study was performed to prospectively assess the results of our first 140 consecutive patients who underwent laparoscopic or laparoscopic-assisted colorectal operations. METHODS: The parameters studied included the type and length of procedure, intra- and postoperative complications, conversion to open surgery, and length of ileus and hospitalization. RESULTS: 140 laparoscopic and laparoscopic-assisted procedures were performed between May 1991 and January 1995. The mean patient age was 48 (range 12-88) years; there were 78 males and 62 females. Indications for surgery included inflammatory bowel disease in 47, colorectal carcinoma in 19, diverticular disease in 17, polyps in 16, familial polyposis in 7, colonic inertia in 7, fecal incontinence in 11, sigmoidocele in 3, irradiation proctitis in 3, rectal prolapse in 2, intestinal lymphoma in 2, and miscellaneous conditions in 6. The procedures included 38 total abdominal colectomies (TAC) (ileoanal reservoir 28, ileorectal anastomosis 8and end ileostomy 2); 70 segmental resections of the colon, small bowel, and rectum; 18 diverting stoma creations; 10 reversal of Hartmann's procedures; and 4 other procedures. In 15 cases, the laparoscopic procedure was converted to a laparotomy (11%); 31 patients (22%) sustained 37 complications, which included: enterotomies(7), hemorrhage(10), intraabdominal abscess(4), prolonged ileus(6), wound infection(4), intestinal obstruction(2), anastomotic leak(1), aspiration(1), cardiac arrhythmia(1), and upper intestinal bleeding(1); there was no mortality. The overall complication rate in TAC cases was significantly higher (42%) when compared to that of all other procedures (segmental resection 17%, others 9%), P < 0.05. The mean length of operating time was 4 (range 2.5-6.5) h for TAC, 2.6 (range 1.5-5.5) h for segmental colonic resections, and 1.7 (range 0.7-4) for all other procedures. The length of ileus was 3.5 (range 2-7) days after TAC, 3 (range 2-7) after the segmental resections and 2 (range 1-4) after the other procedures. The mean length of hospital stay was 6.8 (2-40) days (8.4, 6.5, and 6.3 days for the TAC, segmental resections, and other procedures, respectively). CONCLUSION: The feasibility of laparoscopic colorectal surgery has been well established. TAC is associated with a higher complication rate compared to other laparoscopic colorectal procedures.
机译：背景：本研究旨在前瞻性评估我们首批接受腹腔镜或腹腔镜辅助结直​​肠手术的140例患者的结果。方法：研究的参数包括手术的类型和时间，术中和术后并发症，转为开放手术，肠梗阻的时间和住院时间。结果：1991年5月至1995年1月间进行了140例腹腔镜和腹腔镜辅助手术。患者平均年龄为48岁（12-88岁）。男78例，女62例。手术适应症包括炎症性肠病47例，大肠癌19例，憩室病17例，息肉16例，家族性息肉7例，结肠惯性7例，大便失禁11例，乙状结肠膨出3例，放射性直肠炎3例，直肠脱垂在2例中，肠淋巴瘤在2例中，其他情况在6例中​​。程序包括38例腹部全腹腔穿刺术（TAC）（回肠水库28例，回肠直肠吻合术8例和回肠造口术2例）;结肠，小肠和直肠的70个节段性切除; 18种转移造口的作品; 10逆转哈特曼程序;以及其他4个程序。 15例中，将腹腔镜手术改为开腹手术（11％）; 31例患者（22％）发生37例并发症，包括：肠切开术（7），出血（10），腹腔脓肿（4），肠梗阻（6），伤口感染（4），肠梗阻（2），吻合口漏（ 1），抽吸（1），心律不齐（1）和上消化道出血（1）;没有死亡率。与所有其他手术（节段切除术17％，其他9％）相比，TAC病例的总并发症发生率显着更高（42％），P <0.05。 TAC的平均手术时间为4（2.5-6.5）小时，部分结肠切除术为2.6（1.5-5.5）小时，所有其他手术的平均时间为1.7（0.7-4）。 TAC后肠梗阻的长度为3.5（2-7范围），节段切除术后为3（2-7范围），其他手术后为2（1-4-4）。平均住院时间为6.8（2-40）天（TAC，节段切除术和其他手术分别为8.4、6.5和6.3天）。结论：腹腔镜结直肠癌手术的可行性已得到充分证实。与其他腹腔镜结直肠手术相比，TAC的并发症发生率更高。

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